Timing of nerve transfer for elbow flexion in neonatal brachial plexus palsy

Infants with neonatal brachial plexus palsies (NBPPs) of the upper trunk can suffer permanent loss of elbow flexion. To restore elbow flexion, nerve transfer from an ulnar nerve fascicle to the musculocutaneous nerve branch to biceps, also known as the Oberlin procedure, has reported encouraging outcomes, but the timing of surgical intervention from the time of injury remains controversial. This study is the first to focus on ulnar to musculocutaneous nerve transfer timing in NBPP, and we demonstrate a positive trend in outcomes of elbow flexion and supination in patients intervened on earlier rather than later.