LAUSR

SUMMARY Neuralgic amyotrophy (NA) is a disease affecting peripheral nerves. Historically, treatment has been conservative as the natural course of the disease was thought to be self-limiting. Recent work has demonstrated that as many as two-thirds of those affected suffer from persistent pain, fatigue, or weakness. At our centre, supercharge end-to-side (SETS) nerve transfers are commonly performed in patients with NA to optimize motor recovery while allowing for native axonal regrowth. We describe the technique and clinical outcomes of patients with NA affecting the anterior interosseous nerve (AIN) who were treated with SETS nerve transfer from extensor carpi radialis brevis (ECRB) to AIN. Ten patients (90% male, mean age 51.3 ± 9.7 years) underwent ECRB to AIN nerve transfer at a mean of 6.4 ± 1.4 months following onset of symptoms. Mean postoperative follow-up duration was 14.8 ± 3.2 months. Preoperatively, all patients demonstrated clinically significant weakness in the flexor pollicis longus (FPL), flexor digitorum profundus muscle to the index finger (FDP2), or both. FPL strength improved from a median Medical Research Council (MRC) grade of 1.5 to 4 (p = 0.011) and FDP2 strength improved from a median MRC of 1 to 5 (p = 0.016). A postoperative MRC grade of 4- or greater was achieved in 9 of 10 (90%) FPL and 10 of 10 (100%) FDP muscles. This is the first report of SETS nerve transfer for the treatment of NA. The outcomes of this work suggest that SETS nerve transfers may be an option to optimize the motor outcomes in patients with NA.