Brachioradialis tendon transfers that restore wrist extension: evaluating outcome in different joint postures

After cervical spinal cord injury, brachioradialis, a non-paralyzed elbow flexor, can be surgically attached to a paralyzed wrist extensor, most frequently the extensor carpi radialis brevis, to restore voluntary wrist extension. We hypothesize that the function of brachioradialis at the elbow joint can limit post-operative wrist function. We quantified wrist range of motion, wrist extension strength, elbow extension strength, and the elbow flexion moment produced during wrist extension to evaluate how the transferred brachioradialis functions in different elbow postures. Our data suggest that wrist extension strength needs to be increased when the elbow is flexed and the wrist is extended to improve surgical outcomes.