The radial nerve innervates muscles that extend the wrist, straighten the fingers and allow the thumb to extend. When an injury to this nerve is untreatable, these functions can be restored by time-honored, reliable tendon transfers. Use of donor muscle-tendon units from the same arm does not result in any loss of function.
The Pronator teres tendon is transferred to the ECRB wrist extensor, the FCR or FCU wrist flexor tendon is transferred to the EDC finger extensor tendons, and the Palmaris longus tendon is transferred to the thumb EPL tendon.
Radial tendon transfers are very successful, but the hand and wrist must be kept in a cast for 4 weeks after surgery. A spint is worn for 4 additional weeks, and therapy is beneficial for 2 months after cast removal.
