Introduction: Radial nerve injury can produce a lack of wrist and finger extension. Radial nerve repair or graft or tendon transfers are routinely used to correct this motor dysfunction. We report the use of a nerve transfer to provide direct reinnervation of the wrist and finger extensors.

Purpose: This case study assessed patient outcome following a nerve transfer to correct a radial nerve palsy.

Methodology: One patient who had undergone a nerve transfer from the expendable branches of the median nerve (FDS, FDR and PL) to the radial nerve (ECRB and PIN) was reviewed.

Results: A 60 year old right hand dominant woman fell and sustained a fracture dislocation of her left shoulder that required a hemiarthroplasty. At the time of injury, she noted numbness to her hand and inability to extend her wrist and fingers. Electromyography revealed a brachial plexus posterior cord injury. On follow-up, no recovery to the radial nerve was identified. Three months following nerve injury, a nerve transfer of the expendable branches of the median nerve to the radial nerve was performed. With evidence of muscle reinnervation, postoperative motor reeducation to isolate and strengthen wrist and finger extension was instituted. Full wrist and finger extension was achieved, independent of median nerve function and no median nerve deficit was observed.

Conclusion: Functional deficit following radial nerve injury is significant. A nerve transfer from the median nerve to the radial nerve provides good wrist and finger extension and can be considered in selected patients.