{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T23:17:46Z","timestamp":1788391066600,"version":"build-2803163510"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The use of contralateral C7 (CC7) transfer for brachial plexus injury (BPI) varies considerably across geographic regions and surgical specialties. This study aimed to investigate international variation in the adoption of CC7 transfer and identify factors associated with differences in clinical practice.<\/jats:p>\n                  <jats:p>A questionnaire was distributed to an international cohort of brachial plexus surgeons to evaluate current use of CC7 transfer, training background, practice characteristics, and factors influencing clinical decision-making. Responses were analyzed according to geographic region and surgical specialty.<\/jats:p>\n                  <jats:p>A total of 160 attending surgeons completed the survey, of whom 45.6% performed CC7 transfer. Adoption was highest in Asia and lower in Europe and the Americas. Reasons for non-use varied by region, with lack of prior exposure reported most frequently in North and South America, whereas lack of peer acceptance was more common in Europe. Adoption also varied by specialty, with use reported by 56% of orthopedic surgeons, 53% of hand surgeons, 40% of plastic surgeons, and 30% of neurosurgeons. Prior exposure to CC7 was strongly associated with its use, although 28% of surgeons with previous exposure did not perform the procedure.<\/jats:p>\n                  <jats:p>Substantial geographic and specialty-specific variation exists in the adoption of CC7 transfer. Practice patterns appear to be influenced by multiple factors, including prior exposure, perceived efficacy, peer culture, and local practice patterns. These findings provide insight into the international variation in CC7 adoption and support further investigation into the factors underlying both its use and non-use.<\/jats:p>","DOI":"10.1055\/a-2943-3677","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T23:41:21Z","timestamp":1787355681000},"source":"Crossref","is-referenced-by-count":0,"title":["International Perspectives on Contralateral C7 Transfer for Brachial Plexus Injuries"],"prefix":"10.1055","author":[{"given":"R. Llewellyn","family":"Thomas","sequence":"additional","affiliation":[{"name":"Chang Gung University and Medical College, Chang Gung Memorial Hospital, Taiwan","place":["Taoyuan"],"department":["Department of Plastic and Reconstructive Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaia","family":"Geltser","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center, Texas, United States","place":["Dallas"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommy Nai-Jen","family":"Chang","sequence":"additional","affiliation":[{"name":"Chang Gung Memorial Hospital Linkou Branch, Taiwan","place":["Taoyuan"],"department":["Department of Plastic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6117-5600","authenticated-orcid":false,"given":"David Chwei-Chin","family":"Chuang","sequence":"additional","affiliation":[{"name":"Taipei Municipal Wan Fang Hospital, Taipei City, Taiwan","place":["Taipei City"],"department":["Department of Surgery, Division of Plastic and Reconstructive Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnny Chuieng-Yi","family":"Lu","sequence":"additional","affiliation":[{"name":"Chang Gung Memorial Hospital, Taiwan","place":["Taoyuan"],"department":["Department of Plastic and Reconstructive Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/S0266-7681(05)80235-9","article-title":"Seventh cervical nerve root transfer from the contralateral healthy side for treatment of brachial plexus root avulsion","volume":"17","author":"Y D Gu","year":"1992","journal-title":"J Hand Surg [Br]"},{"key":"ref2","first-page":"179","volume-title":"C7 Transfer","author":"W-D Xu","year":"2013"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.5772\/67948","volume-title":"Nerve Transfers in the Treatment of Peripheral Nerve Injuries","author":"V Vanaclocha","year":"2017"},{"issue":"08","key":"ref4","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1007\/s00381-023-05942-z","article-title":"Contralateral C7 nerve transfer for severe pediatric brachial plexus injuries: donor site morbidity","volume":"39","author":"N D Bhagat","year":"2023","journal-title":"Childs Nerv Syst"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1515\/revneuro-2021-0122","article-title":"Contralateral C7 nerve transfer in the treatment of upper-extremity paralysis: a review of anatomical basis, surgical approaches, and neurobiological mechanisms","volume":"33","author":"Y Bai","year":"2022","journal-title":"Rev Neurosci"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"480e","DOI":"10.1097\/PRS.0000000000001616","article-title":"A systematic review of outcomes of contralateral C7 transfer for the treatment of traumatic brachial plexus injury: part 2. 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