Function of the wrist and hand in lower root avulsions is severely impaired. Based on anatomic and experimental studies which suggest that the motor nerve of the brachialis muscle could be used as a selective neurotizator in lower root avulsions with intact C5-C6 +/- C7 roots (Klumpke paralysis), we considered its use depending on the target. We describe two techniques for the median nerve (in C8-T1 avulsions) and one for the radial nerve (in C7-C8-T1 avulsions). In all cases, we added the lateral cutaneous nerve of the forearm in the neurotization to improve sensibility in the hand. The present report presents the results of its use in our first five patients.