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Bryan et al. Plast Aesthet Res 2022;9:53 https://dx.doi.org/10.20517/2347-9264.2022.39 Page 5 of 12

Figure 2. Illustration of relevant anatomy for nerve to the ECRB to AIN nerve transfer technique. The donor nerve to the ECRB is
transferred to the recipient AIN. AIN: Anterior interosseous nerve; ECRB: extensor carpi radialis brevis.

Figure 3. (A) Identification of the AIN branching from the median nerve. (B) Identification of the PIN and nerve to ECRB. (C) The donor
nerve to the ECRB is transferred to the recipient AIN. The nerve to the supinator (NTS) is also transferred to the PIN. AIN: Anterior
interosseous nerve; ECRB: extensor carpi radialis brevis; PIN: posterior interosseous nerve.

within 8 months of injury . At 13 months postoperatively, all patients regained full finger and thumb
[23]
flexion with grade MRC grade 4 strength . Another study by Bertelli et al. compared surgical outcomes of
[23]
9 patients and 17 limbs after cervical spinal cord injury . Nerve to the brachialis to AIN transfer was
[24]
performed in 3 limbs, brachialis to other median nerve motor fascicles in 5 limbs, brachioradialis to AIN in
4 limbs, and nerve to the ECRB to AIN in 5 limbs. Finger flexion restoration was only observed in 4/8 limbs
with brachialis transfer, with 3 limbs achieving MRC grade 3 flexion and one limb achieving MRC grade 4
flexion. Similarly, brachioradialis to AIN transfer showed incomplete flexion with MRC grade 4 strength.
Meanwhile, ECRB to AIN had the best reported outcomes, with MRC grade 4 strength and full finger
flexion in all 5 limbs and no downgrading of wrist extension or elbow flexion . Salomão et al. most
[24]
recently reported a single case report of a 29-year-old male who sustained a gunshot wound and received
ECRB to AIN transfer 16 months after injury . At a 2-year follow-up, the patient regained full flexion with
[25]