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Traumatic brachial plexus injuries (BPI) can cause permanent disability of the upper extremities. Several treatments are available for repairing upper trunk or total BPIs, whereas few methods exist for repairing injuries to the lower trunk of the brachial plexus. Among these treatments, nerve transfer and tendon transfer are two common approaches. Free gracilis muscle transfer can be used to restore elbow and finger function after devastating BPIs. The contralateral C7 (CC7) nerve and the intercostal nerve are mainly used as donor nerves to restore hand function when transferring the gracilis muscle. However, the outcomes of using these donor nerves are controversial.