A method to improve wrist extension in the severely paralyzed hand has been described. The ability to dorsiflex the wrist and to perform automatic grasp is one of the quadriplegic's most important functions. Four of six hands with transfer of a good or normal brachioradialis to weak or absent radial wrist extensors gained this most important function with effective grasp. The other two had improved posture of their hands and were pleased with their results.