在臂丛损伤中，全臂丛撕脱伤危害最为严重。健侧颈7神经移位已成为治疗全臂丛撕脱伤的主要术式。然而手内肌作为人类特有的肌肉，控制精细动作，其恢复一直是个难题。我们术后随访发现健侧颈7移位术可使拇短展肌再生，提示手内肌恢复是可能实现的。如何在传统健侧颈7移位基础上改良，进一步恢复手内肌功能？传统的健侧颈7移位使尺神经深支丧失近端支配，导致大部分手内肌丧失再生可能。若能使尺神经深支成为健侧颈7神经的目标神经，则手内肌存在再生希望。因此，我们提出方案设计：健侧颈7I期：于腕部切断尺神经，将桡浅神经游离后，将其远端与尺神经深支相吻合。将尺神经主干逆行吻合至健侧颈7神经根。健侧颈7II期：将腋部尺神经切断后分束，分别吻合至正中神经及桡神经外侧部分的神经束。我们将从解剖学研究，动物实验及临床研究三方面证实该术式的可行性和有效性。若能成功实现手内肌再生，则该术式有希望成为世界首创，为全臂丛撕脱患者带来福音。

Total brachial plexus avulsion is the most serious in brachial plexus injuries. Contralateral seventh cervical nerve (CC7) transfer plays a key role in the treatment of total brachial plexus avulsion. However, as the unique human muscles to control fine movements, the recovery of the intrinsic muscles remains a difficult problem. Our previous postoperative follow-ups showed that abductor pollicis brevis could be regenerated by CC7 transfer, which indicated the recovery of intrinsic muscles would possibly come true. Therefore, how could we make improvement for the intrinsic muscles recovery on the basis of traditional CC7 nerve transfer? In the traditional CC7 nerve transfer, the deep branch of ulnar nerve is lack of the domination of proximal nerve, which results in the loss of most intrinsic muscles regeneration. If the deep branch of ulnar nerve could become the target nerve of the contralateral seventh cervical nerve, the regeneration of intrinsic muscles would be possible. We propose a surgical scheme design. CC7 transfer stage I: the ulnar nerve is cut off at wrist and separated from the wrist to the axilla. The distal end of the ulnar nerve is sutured to the whole contralateral seventh cervical nerve through the subcutaneous tunnel. The superficial radial nerve is separated in the forearm and its distal end is sutured to the deep branch of ulnar nerve. CC7 transfer stage II: The ulnar nerve, median nerve and radial nerve are exposed and cut off respectively in the axillary incision. The ulnar nerve is sutured to both median nerve and the nerve bundles in the lateral part of the radial nerve. We will confirm the feasibility and validity of the operation from three aspects: anatomical study, animal experiment and clinical study. If the regeneration of intrinsic muscles comes true, the improved CC7 transfer will be a pioneering operation in the world, which will bring good news to the patients with total brachial plexus avulsion.