Transposición tendinosa con el palmar mayor para restablecer la extensión de los dedos en la parálisis del nervio radial

introduction: when tendinous transfers are carried out to restore the finger extension due to radial nerve paralysis, there are controversies in the decision of which muscle be used, the anterior cubital one or the palmaris major. the objective of present research is to show our experience with the use of the palmaris major muscle. methods: a longitudinal study was conducted in 39 patients diagnosed with radial nerve paralysis, where we assessed the functional results of tendinous transpositions to restore the finger extension. the palmaris major was used in 27 patients, 15 by subcutaneous route and 12 through the interosseous membrane and the anterior cubital one was used in 12 patients as control group. results: the assessment of the extension of fingers metacarpophalangeal joints was excellent and good in 37 of the 39 patients without statistic association in relation to the muscle used. the flexor muscular strength of wrist after surgery decreased at grade 3 in 11 of the 12 patients in which we used the anterior cubital one unlike those used the palmaris major where the strength was of grade 4 in 17 of the 27 patients. the more frequent complication was the wrist radial deviation present in 4 patients in which we used the anterior cubital one. conclusions: the palmaris major muscle is the more recommended alternative to restore the fingers extension in radial nerve paralyses.