Radial nerve palsy (RNP) is a type of nerve injury that is characterized by wrist extension, finger extension, thumb extension and abduction dysfunction, as well as skin sensory impairment in the palm area. RNP is a common complication of humeral shaft fracture caused by upper limb trauma, and the incidence of RNP is about 2% to 17% [1], [2]. The radial nerve is the most vulnerable upper limb nerve due to its special anatomical structure [3]. RNP is classified into three categories: primary, secondary and delayed. Spontaneous recovery of the radial nerve can occur in most patients, and there is controversy regarding early surgical exploration [4]. For patients with surgical indications for RNP, such as traumatic nerve dissection, surgical treatment is usually required through nerve repair, nerve transfer or tendon transfer to reconstruct the injured nerve to achieve the therapeutic goal of restoring hand function [3]. However, in current clinical treatment of RNP, nerve transfer and tendon transfer have their respective advantages and disadvantages, leading to the selection of surgical methods based primarily on the patient's own will and the surgeon's clinical experience. Therefore, it is necessary to compare the long-term postoperative efficacy of the two kinds of surgery to guide clinical treatment of RNP [5]. This study aims to explore the timing of RNP treatment intervention and the choice of surgical methods by comparing the long-term efficacy of nerve versus tendon transfer for the reconstruction of hand function in patients with RNP.