Twenty-three patients with absent elbow flexion secondary to brachial plexus injury underwent nerve transfer using 1 or 2 fascicles of the ulnar nerve to the motor branch of the biceps muscle. Seven patients had root avulsion injury of C5 and C6; 12 had root avulsion injury of C5, C6, and C7; 1 had root avulsion injury of C5, C6, C7, and C8 and 3 had lateral and posterior cord injury with distal injury of the musculocutaneous nerve. The average reinnervation time for the biceps after surgery was 3.8 months. Seventeen patients were followed for longer than 1.5 years. Thirteen patients had biceps strength of M4, 2 patients had biceps strength of M3, and 2 patients had biceps strength of M2. Four patients experienced transient paresthesia in the small finger. Grip strength, and Semmes-Weinstein test in the small finger were measured before and after surgery. No loss of ulnar nerve function was noted after surgery.
