Oberlin nerve transfer: choosing double or single fascicle

Oberlin transfer is commonly used to restore elbow flexion. Single or double fascicle can make a difference for you, but from a medical point of view, surprisingly it doesn't.

The medical objective is to reach M3, which can be accomplished by just a single transfer from the ulnar nerve to the biceps. Pros are basically a lesser chance of side effects of a nerve transfer happening, like accidentally damaging the nerve or residual weakness in the hand. Cons are, basically, less strength on your elbow flexion.

A double fascicle transfer will additionally innervate the brachiallis from the median nerve. Arm movement might be similar to single fascicle transfer (or that's the general believe), but about half of the elbow flexion's strength comes from this muscle according to physicians. To you, his means you might not be able to pull up that box of milk anymore when carrying groceries - although this is just an speculation from my side.

A double transfer will be more expensive, and it is time consuming on a lengthily surgery.

Some doctors mentioned to me that a single transfer is good enough, and a double transfer is a risk for residual weakness in the hand. Other doctors are pro double transfer, since it will provide more strength and provide a relatively better life quality for the patient - closer arm strength to what it was.

I had a double transfer, and I am very satisfied with it. It is true that my hand was weak for some time, specially the index finger, but it recovered. I started to exercise the hand every day with a kit similar to this one in amazon (hand grips family), and 10 months later, the right hand's strength is pretty much the same as my left hand.

To describe how this temporary weakness was to me, right after the surgery, I couldn't press the shaving foam trigger, for example. Pressing the buttons on my watch was challenging. Even pressing the toothpaste tube felt hard. But as mentioned before, it came to pass several month later.

I've heard of people who, right after the surgery, couldn't make a fist. They also had their hand strength back, although I don't know to what extend.

When I activate my biceps (i.e. closing my ring and pinkie fingers), the forearm supinates then it raises. I can raise my forearm without supination using the brachiallis. I am not sure if you can achieve the same motion with a single transfer.

My personal opinion on this, a double transfer is worth it.