ABSTRACT
Background: Radial nerve palsy had disabling effect on hand function, leads to loss of power grip due to lost extension. Many surgical procedure was described to restoring function, tendon transfer is an important option due to bad reputation of nerve repair. The donor site from muscle supplied by the median and ulnar nerves.
Aim of work: Evaluation of different methods of tendon transfer for management of wrist and finger drop in radial or PIN palsy.
Patient and Methods: 20 patients with radial or PIN palsy. Presented with post traumatic injury, 14cases in the arm with total radial nerve, 6cases in forearm with PIN. Various techniques of tendon transfer were used including FCU transfer, FCR transfer, and FDS transfer to the EDC.  In cases with high radial injury, PT to ECRB transfered to restore wrist extension and palmaris for thumb extension.
Results: This study included 20patients in three groups, the FCR group including 9patients, the FCU group including 6patients, and the FDS group including 5patients. In FCR group, 6patients(66.6%) were excellent, 2patients(22.2%) were good and 1patient(11.1%) was fair. In FCU group, 3patients(50%) were excellent, 2patients(33.3%) were good and 1patient(16.7%) was fair. In FDS group, 3patients(60%) were excellent, 1patient(20%) was good and 1patient(20%) was fair according to an objective evaluation. 
Conclusion: The tendon transfer is a very successful treatment for irreversible radial nerve paralysis, many techniques of tendon transfer were prescribed for treatment of wrist and finger drop. The FCR transfer is the best option for restoration of hand extension Because it preserves the important moment of flexion and ulnar deviation of the wrist which is important for power grip in working men and it's transfer is easier, quicker and associated with less intra-operative dissection and less donor site morbidity.