Brachialis-to-extensor carpi radialis longus selective nerve transfer to restore wrist extension in tetraplegia: case report.

Active wrist extension allowing tenodesis grip is the key function in high-level tetraplegic patients. It is absent and cannot be restored by traditional tendon transfer in patients who have no transferable muscle below the elbow. We present a 36-year-old man with high-level tetraplegia treated 12 months after injury who regained active wrist extension after transfer of the brachialis muscle branch of the musculocutaneous nerve to the extensor carpi radialis longus muscle branch of the radial nerve. No functional deficit of elbow flexion occurred after reconstruction.