Surgeon Natasha van Zyl completes a nerve transfer


In this section, you can find the following information:

Upper Limb Program

Nerve and tendon transfer surgery is performed by Austin Health's Upper Limb program, a specialist program that aims to maximise upper limb function for people with tetraplegia (paralysis of all four limbs and the trunk) and other neurological conditions (such as stroke and acquired brain injuries).

The program is a collaboration between our plastic and reconstructive surgeons and Upper Limb occupational therapists, rehabilitation physicians and physiotherapists.

Together, they work closely with you, your carers and family to help you reach the best limb function possible.

Our team was one of the first in the world to introduce the nerve transfer technology for spinal cord injuries. We were also the first worldwide to do multiple nerve transfers simultaneously to reconstruct upper limb function for people with quadriplegia.

Austin Health is one of only two sites in Australia where there is an established nerve transfer surgery program within a spinal cord service.

We have a strong focus on research and evidenced-based practice and enjoy a high international profile on this topic.

What we do

Our main focus is nerve and tendon transfer surgery to give people back arm and hand function following injury or other neurological damage.

We have extensive experience in improving upper and lower limb position and/or function for those who have had a stroke or acquired brain injury, or who cerebral palsy and multiple sclerosis. This is achieved using tendon lengthening and tendon transfer surgery combined with the appropriate use of intramuscular Botulinum toxin, splinting and strengthening therapy.

We also treats peripheral nerve injury in the upper or lower limb using tendon or nerve transfers.

See some of the results of our surgery:

The patients in these videos underwent single or multiple nerve transfers in one or both upper limbs to restore elbow extension, grasp, pinch and hand opening. The outcomes of their surgery were published in a research article in The Lancet. Before having surgery, none were able to perform the grasp or pinch strength tests, but two years later, they had gained enough pinch and grasp strength to do most activities of daily living.


One of our patients with a level C6 spinal cord injury 13 months after right triple nerve transfer surgery.


Active hand opening and closing 24 months after nerve transfer surgery.


Patient discussing different reconstructions for grasp and pinch 24 months after surgery in the right and left limbs.

The results of these procedures are also summarised nicely in media coverage below, from 9 News:

Acknowledgement flags

Austin Health acknowledges the Traditional Custodians of the land and pay our respects to Elders past, present and emerging.
We celebrate, value and include people of all backgrounds, genders, sexualities, cultures, bodies and abilities.