NERVE TRANSFERS FOR BRACHIAL PLEXUS RECONSTRUCTION AFTER TRAUMA (HB 2025)

Brachial plexus injury (BPI) is one of the most functionally devastating injuries, as it causes substantial debilitation and long-term difficulties in daily activities. The burden for the patient and the caregiver may arise not only from neurological disability but also from psychosocial and socioeconomic factors.
This injury is more prevalent among young men aged 15 to 25 and is primarily caused by road accidents, especially those involving motorbikes. Other significant causes include obstetric injuries, severe trauma from falls, direct or blunt blows, penetrating injuries, forced traction, and compression injuries.
If a nerve has been divided by a sharp laceration, it can usually be repaired with a direct suture. If a nerve tract has been damaged, as is often the case when it has been subjected to severe traction injuries, repair will require a nerve graft. 

Brachial plexus nerve grafts are typically required for lacerations to achieve a tension-free repair. While neurolysis, nerve repair, and nerve grafting have been employed to address stretching plexus injuries, nerve transfers utilize an undamaged nerve to provide motor input over a relatively short distance to reinnervate a denervated muscle. This approach has become the preferred and most extensively studied technique for nerve repair today, with numerous pathways aiming to enhance functional outcomes. 
So far, no comprehensive effort has been made to categorize and classify the various nerve transfer techniques and procedures for BPI patients; this is the first book to accomplish that. Neurosurgeons, plastic surgeons, orthopedic surgeons, and hand surgeons must understand and select the most effective methods for treating their BPI patients.

Fernando Guedes is a professor of Neurosurgery and chief of the Division of Neurosurgery at the University Hospital Gaffrée e Guinle(UHGG),of the Federal University of Rio de Janeiro State (UNIRIO).Prof. Guedes is a former co-chairman of the Department of Peripheral Nerve Surgery at the World Federation of Neurosurgical Societies (WFNS),and has been an enthusiast for the practice and teaching of Neurosurgery for the past decades in Brazil and in the world.Among his research interests,Prof.Guedes has published several papers and books concerning peripheral nerve and brachial plexus traumatic injuries, peripheral nerve tumors in adults and in childhood, brachial and lumbosacral plexus tumors, and neuropathic pain.

Christian Heinen pursued his medical studies in Halle/Saale and Ulm (Germany),and in Bologna (Italy).He obtained the nurosurgical specialization at the Department of Neurosurgery, University of Ulm in Günzburg in 2011.After a long period spent as a senior physician at the Department of Neurosurgery,University Oldenburg,he currently is Head of the Neuro, Spine and Nerve Surgery  at the Christliches Krankenhaus in Quakenbrück (Germany).Moreover, he is Past chair of the peripheral nerve section of German society of neurosurgery DGNC.

Lukas Rasulic is a Professor at the Faculty of Medicine, University of Belgrade,and serves as the Head of the Department of Peripheral Nerve Surgery, Functional Neurosurgery, and Pain Management Surgery at the Clinic for Neurosurgery, University Clinical Centre of Serbia. He is a President of the Serbian Neurosurgical Society and Secretary of the European Association of Neurosurgical Societies (EANS). He is also the Founder, Past President, and Honorary President of the Southeast Europe Neurosurgical Society. Furthermore, he has served as the Past Chairman of the World Federation of Neurosurgical Societies (WFNS) Peripheral Nerve Surgery Committee and has held the position of Past Chair of the EANS Section for Peripheral Nerve Surgery. His primary areas of clinical and scientific focus are centered on peripheral nerve surgery. To date, he has published over 800 scientific articles in both international and national indexed journals, as well as numerous chapters in scientific books.

Alexander Y. Shin is an orthopedic hand and microvascular surgeon with specialty interest in complex upper extremity. He graduated from the University Of Pennsylvania School Of Medicine in 1990. He currently is a consultant at the division of Hand Surgery at the Mayo Clinic in Rochester, and Professor of Orthopedic Surgery and of Neurosurgery at the Mayo Medical School. His research interests span the realm of both clinical and basic science problems. Clinically, he studies outcomes and compares treatment options in patients with hand and upper extremity problems including fractures, soft tissue injuries, arthritis, tumors and nerve injuries. Within the basic science field, his focus is on the enhancement of peripheral nerve regeneration by alteration of the local environment using stem cells, exosomes, surgical angiogenesis and modulation of the local immune response.

Mariano Socolovsky is Chief of the Department of Neurosurgery at the Hospital de Clínicas, University of Buenos Aires School of Medicine. As he is specialized in peripheral nerve surgery, he runs the Unit of Peripheral Nerve Surgery and is Co-director of the Program for Treatment of Peripheral Nerve & Brachial Plexus Surgery, together with the Department of Neurosurgery, Orthopedics and Physiotherapy at the aforementioned medical institution. He also acted as Chairman of the World Federation of Neurosurgical Societies’ Peripheral Nerve Surgery Committee(2013-2019) and is at present Vice-President of the Argentine Society of Neurosurgery (2020-2022). He has authored more than 60 Pubmed articles, 50 book chapters and 10 books.