Tendon transfers in the innervation area of the median nerve in brachial plexus palsy

Brachial plexus lesions generate complex paralysis and deficient sensitivity in the concerned upper extremity. The clinical features are represented in numberless variations, and in any case several nerves will be involved. Isolated median nerve palsies can only be produced by a lesion of its single terminal branch. For this reason, any secondary surgery aiming at restoring muscle function in the median nerve area should consider the entire upper extremity as a functional unit. Using special ''charts'' will give a better overview and simplify the choice for the most convenient muscles to transfer.