In the absence of war, there have been few patients requiring microsurgical reconstruction of injuries to the median nerve where the location of the median nerve injury is proximal to the elbow. Available microsurgical techniuqes for nerve reconstruction will permit the sensory component of the median to reach the thumb and index finger in about three years after the reconstuction.

The present report describes the successful neurotization of the thumb and index from the radial sensory nerve in order to provide sensibility for pinch.

The first patient is a 21 year old right handed baseball pitcher who had 23 cm of the right median nerve removed during a tendorn reconstruction. The second patient is a 53 year old right handed man with a glass laceration of the median and ulnar nerve in the right axilla.

The strategy transferred the dorsal sensory branches of the radial nerve into the ulnar digital nerve of the thumb and the radial digital nerve of the index finger. By three months after surgery, in each patient, there was sufficient sensation to provide protection of the these fingers. By six months, there was sufficient sensibility to permit active lateral key pinch. The results at one year for each patient will be presented along with the sensory rehabilitation protocol.