Double Fascicular Transfer: Median Fascicle to Biceps Branch and Ulnar Fascicle to Brachialis Branch

Video Description

The double fascicular transfer (DFT) includes two nerve transfers: (1) median fascicle to biceps branch and (2) ulnar fascicle to brachialis branch. The median fascicle contains nerve fibers that innervate flexor digitorum superficialis / flexor carpi radialis. The ulnar fascicle contains nerve fibers that innervate flexor carpi ulnaris. The donor fascicles can be used for either recipient nerves depending on the length required, but the nerve transfers described above are typically used. The DFT is used to restore elbow flexion when median and ulnar nerves are intact.

Table of Contents
00:30 Orientation
00:35 Incision / Exposure
02:00 Identification of the Medial Antebrachial Cutaneous Nerve
03:00 Identification of the Donor Median Nerve
03:44 Distal and Proximal Identification of the Recipient Musculocutaneous Nerve and Branches
06:28 Identification of the Donor Ulnar Nerve
07:19 Transecting the Musculocutaneous Nerve Proximally
07:41 Isolating the Biceps Brachii, Brachialis, and LABC Branches from the Musculocutaneous Nerve
10:15 Determining the Location of Intraneurolysis and Appropriate Donor Nerve for Transfer
11:58 Intraneurolysis of the Median Nerve to Isolate the FCR/FDS Nerve Fascicle
14:42 Intraneurolysis of the Ulnar Nerve to Isolate the FCU Nerve Fascicle
18:20 Preparing Recipient Nerves by Removing Extra Epineurial Tissue and Excess Proximal Nerve
19:04 Transection and Transfer of the FCU Nerve Fascicle to the Brachialis Nerve Branch
20:45 Transection and Transfer of the FCR/FDS Nerve Fascicle to the Biceps Brachii Nerve Branch

Narration: Susan E. Mackinnon
Videography: Andrew Yee

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