Active elbow extension by the triceps allows for overhead reach and stabilizes the hand in space, increasing the functional workspace of the hand. In a brachial plexus injury (BPI) patient, loss of elbow extension can be facilitated by gravity. Triceps function is imperative for overhead activity if patients have shoulder function with abduction and forward flexion greater than horizontal. Patients with C5–C7 or upper and middle trunk injuries may have triceps recovery by C8 reinnervation. Patients with complete pan plexus injuries are unlikely to have spontaneous triceps recovery. Elbow flexion and shoulder function are the primary goals in brachial plexus reconstruction. However, when reconstructing prehension for complete pan BPI patients with a gracilis free functioning muscle transfer (FFMT), it is important to restore active elbow extension so that the gracilis excursion will result in distal function, such as wrist extension or finger flexion, instead of just flexing the elbow [1].