Progress in treatment of brachial plexus injury with accessory nerve transfer

The use of the accessory nerve as a donor is one of the best possibilities for treatment of the brachial plexus in case of paralysis due to root avulsion. In this paper, a brief history of the use of accessory nerve tran sfer for treatment of brachial plexus injury and recent development in the anato my of accessory nerve are introduced. The nerve transfer methods and the effects of the accessory nerve are discussed in particular. The progress in and the dev elopment trend of the accessory nerve transfer methods are also analyzed. It is advisable that the accessory nerve is transferred to restore the suprascapular n erve so as to obtain shoulder abduction. And it is a clinical trend that the dis tal terminal branch of the accessory nerve is used and the function of the upper part of the trapezius muscle is preserved in the transfer. At last, the factors affecting functional outcome in accessory nerve transfer are discussed.