The bases of the reconstructive surgery of brachial plexus are currently well established; but the number of patients victim of a serious paralysis increase constantly and the roots avulsion are frequent. In these cases, the search for better functional results guides surgeons to use selective neurotizations. Preference is given for those that don't need the interposition grafts. Lesions C8-T1 of brachial plexus are rare: they only represent about 5% of the traumatic lesions. In this cases, to reestablish hand function, the only possible treatment is a musculo-tendinous transfer. The problem is even more serious when there is a lesion of C7 in addition: in this case, possibilities of musculo-tendinous transfer are much reduced. The authors present the direct anastomosis between the nerve of brachialis muscle with the epitrochlear branch of the median nerve to use in those C7-C8-T1 root avulsions. Considering that the musculocutaneous nerve branches innerving brachial muscle has origin in C5-C6 roots and the elbow flexion is assured by biceps brachial muscle, we tried to re-establish flexors muscles function of the wrist and fingers by a neurotization of epithroclear branches of the median nerve by musculocuteous nerve branches of the brachial muscle. In all our dissections, we were able to achieve a tensionless neurorrafy with the proximal stumps of the brachialis branches of the musculocutaneous nerve with the distal stump of the epitrochlear branches of the median nerve. Morphometric studies showed compatibility between myelinazed nerve fibers number in both nerve branches.