Muhammad Saaiq - Consultant Plastic surgeon and Head of Plastic Surgery Department, National Institute of Rehabilitation Medicine (NIRM), Islamabad, Pakistan

Background: This randomized clinical trial was carried out to document the clinical presentation of isolated highradial nerve palsy (high RNP) and compare the outcome of triple tendon transfers.Methods: The study included patients of all genders and ages who presented with isolated high RNP. Half of themwere randomly assigned to the flexor carpi radialis set (FCR-set) of tendon transfers (group A) and a half to theflexor carpi ulnaris (FCU-set) of tendon transfers (group B).Results: Out of ۴۴ patients, ۳۸ were males, and ۶ were females. The age ranged from ۷ years to ۵۵ years.۲۶(۵۹.۰۹%) patients had primary RNP in association with fractures of the humerus. The postoperative meandisability of arm, shoulder, and hand score (Quick DASH-۱۱ score) for the patients in the FCR-set of transfers was۳۴.۵۴%% versus ۴۱.۸۱% for the FCU-set of transfers. ۱۱ patients (۲۵%) developed radial deviation deformity.Conclusion: RNP was predominantly found among males of the young age group, and the majority of the casesresulted from preventable causes. The triple tendon transfers among patients of the two groups robustly restoredthe lost extension of the wrist and digits in a matching way. The patients also subjectively reported remarkableimprovement in terms of the favorable Quick-DASH-۱۱ scores. Radial deviation deformity occurred among half ofthe patients who underwent the FCU set of tendon transfers.Level of evidence: II

High radial nerve palsy, Flexor carpi radialis, Flexor carpi ulnaris, Quick-DASH-۱۱ scores, Tendon transfers