The nerve to ECRB arises from the radial nerve or its superficial branch at or just above the lateral epicondyle, entering the ECRB from its deep surface. In approximately 30% of individuals a separate branch from the posterior interosseous nerve supplies ECRB after it enters the radial tunnel.
The ECRB nerve branch is the key motor territory distinguishing posterior interosseous nerve palsy (ECRB spared if injury is distal to its takeoff) from radial nerve palsy at the spiral groove (ECRB paralysed). Its variable origin explains why PIN palsy produces variable ECRB involvement. ECRB nerve to muscle transfer is used in radial nerve reconstruction.
Variable ECRB involvement in posterior interosseous nerve palsy depending on whether the ECRB branch arises proximal or distal to the arcade of Frohse, producing inconsistent wrist extension deviation in PIN injuries that must be accounted for in functional assessment.
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