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Background: Resuming lost function of the hand in chronic radial nerve palsy has a great value. Tendon transfer procedures for radial nerve palsy are playing a major role. There is about a hundred years of challenging history behind these procedures. Numerous studies were done to describe two combinations of muscles for transfer; the point is using the flexor carpi ulnaris or the flexor carpi radialis to restore the fingers’ extension. There are some differences in cosmetic and functional results of these surgical plans. This study was done to compare these two procedures.

Methods: The place of study was AL Zahra hospital, Esfahan University of medical sciences, Esfahan, Iran.41 known cases of chronic radial nerve palsy that had the inclusion criteria were selected during 2001 to 2007. They had divided into 2 groups randomly. In one group we used flexor carpi radialis (FCR) and in the other one we used flexor carpi ulnaris (FCU) to restore fingers (metacarpophalangeal joint) extension. Post-operative plan was the same in both groups. A questionnaire was designed and each patient was evaluated by physical exam. The collected data was analysed by SPSS software. The chi square test, T test and Fischer test were used for data analysing.

Results: There was significant difference between fingers active extension, Ulnar deviation and cosmetic results in two groups (P value <0.05).The difference between wrist extension, infection and scar formation was not significant (P value >0.05).

Conclusion: The use of FCR method had better results in our study. We recommend this method if the patient does not have any contra indications