Immediate tendon transfer with primary nerve repair in peripheral nerve injuries of the upper extremity.

Abstract

Peripheral nerve injuries (PNIs) in the upper extremity can lead to significant functional deficits, impacting quality of life. Traditional management often involves delayed tendon transfer after nerve regeneration fails or proves insufficient. However, immediate tendon transfer combined with primary nerve repair has emerged as a promising strategy to restore function early while awaiting nerve recovery. This review explores the rationale, indications, surgical techniques, outcomes, and controversies surrounding this approach, supported by clinical evidence and biomechanical considerations.