A branch of the radial nerve arising just above or at the lateral epicondyle, before or at the division into superficial and deep radial branches, supplying the ECRL. Its takeoff is proximal to the PIN division, so ECRL function is preserved in posterior interosseous nerve palsy.
The ECRL nerve branch is the key differentiating motor territory between radial nerve palsy (ECRL paralysed — wrist drops into ulnar deviation during extension) and PIN palsy (ECRL preserved — wrist extends with radial deviation but fingers cannot extend). EMG of ECRL confirms the level of injury.
Preserved ECRL EMG activity with absent EDC and EIP function confirms posterior interosseous nerve palsy (wrist extension with radial deviation) rather than radial nerve trunk palsy.
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