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After nerve reconstruction has taken place, it is important that the patient be very much engaged in their rehabilitation. When a patient has been treated with a nerve transfer, it is important for them early on to begin to activate the muscle from which that nerve is transferred. For example, when a nerve that goes to hand closing and wrist flexion is transferred to the biceps, we ask the patient to begin to engage in daily activities where they clench the hand numerous times and flex the wrist with about 30 to 50 reps per time, three times a day. Patients who engage in this activity often see quicker and more robust results than patients who don’t. If a patient has suffered a brachial plexus injury, even if it is recovered well, sometimes that limb is left with fewer axons where those muscles are being supplied by a less robust nerve that is incompletely recovered. This makes a patient more prone to injuring those nerves in a more severe fashion the next go around. So if a patient suffered significant weakness to the limb, even if it is fully recovered, that patient is at risk for similar damage to that limb in the future if he experiences similar trauma.
