A, When both radial wrist extensors are active, extensor carpi radialis longus can be used to help provide finger flexion; thumb flexion may benefit from transfer of active extensor carpi radialis tertius when present (see text). B, Key pinch is obtained with wrist extension by active extensor carpi radialis brevis with tenodesis to flexor pollicis longus. To achieve correct tension, with wrist in complete passive extension, flexor pollicis longus tendon is sutured to extensor carpi radialis when pinching is produced. C, With passive wrist flexion, pinch is released.