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Combined flexor carpi ulnaris and flexor carpi radialis transfer for restoring elbow function after brachial plexus injury
  1. Pichitchai Atthakomol1,
  2. Sezai Ozkan2,
  3. Neal Chen2 and
  4. Sang-Gil Lee2
  1. 1 Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  2. 2 Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Pichitchai Atthakomol, p.atthakomol{at}


The result of combined agonist and antagonist muscle innervation in traumatic brachial plexus injury through the intraplexal fascicle nerve transfers with the same donor function has not yet been reported. We describe a patient with a C5–C7 traumatic brachial plexus injury who had a combined transfer of the flexor carpi radialis (FCR) fascicle to the musculocutaneous nerve and the flexor carpi ulnaris (FCU) fascicle to the radial nerve of the triceps. The patient returned for his follow-up visit 2 years after his surgery. The muscle strengths of his triceps and biceps were Medical Research Council grade 2 and 0, respectively. Compared with his uninjured side, his grip strength was 9.8%, and his pinch strength was 14.2%. Our case report provides insights on result of combined agonist and antagonist muscle innervation through combining the motor fascicle of the FCR and FCU to restore the elbow flexor and extensor. The result may not be promising.

  • trauma CNS/PNS
  • surgery
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  • Contributors PA contributed to conception and design, acquisition of data or analysis and interpretation of data. SO, NC and S-GL analysed and interpreted the data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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