Objective:

To evaluate clinical outcomes of ICN-to-MCN transfer in elderly patients and identify perioperative factors associated with meaningful functional recovery, defined as achieving at least M3 elbow flexion.

Approach:

Key Findings:

• Elderly patients represented less than 1.6% of ICN-to-MCN transfers.
• One patient with early reconstruction achieved useful elbow flexion (M4), demonstrating the importance of timing.
• Delayed surgery beyond 5 months resulted in limited or absent recovery (M0–M2), underscoring the critical window for intervention.

Interpretation:

ICN-to-MCN transfer can be effective in elderly patients if performed early and under favorable conditions, emphasizing the necessity for tailored treatment plans based on individual patient factors.

Limitations:

• Small sample size limits generalizability and may introduce selection bias.
• Lack of diverse demographic representation.

Conclusion:

ICN-to-MCN transfer is a viable option for selected elderly patients, with outcomes significantly influenced by timing and rehabilitation efforts.

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