Wrist Drop: Causes, Clinical Presentation, Investigations, and Treatment

Wrist drop, also known as radial nerve palsy, is a condition where an individual is unable to extend their wrist and fingers due to injury or compression of the radial nerve. This article delves into the causes, symptoms, diagnostic methods, and treatment options for wrist drop.

Etiopathogenesis of Wrist Drop

The radial nerve, originating from the brachial plexus, is responsible for innervating the extensor muscles of the forearm, wrist, and fingers. Injury to the radial nerve leads to dysfunction, resulting in wrist drop.

Causes of Wrist Drop

• Trauma: Direct injury from fractures, such as humeral shaft fractures.
• Compression: Prolonged pressure on the radial nerve, often due to improper positioning or tourniquet use.
• Neuropathy: Conditions such as diabetes-induced neuropathy or lead poisoning.

Clinical Features

Patients with wrist drop exhibit:

• Inability to extend the wrist and fingers.
• Weakness in grasping objects.
• Loss of sensation in the dorsal aspect of the hand.

Investigations

Diagnostic tools include:

• Nerve Conduction Studies: To assess nerve function.
• Electromyography (EMG): To evaluate muscle activity.
• Imaging: X-rays or MRI to identify fractures or soft tissue compression.

Management and Treatment

Non-Surgical Treatment

• Physiotherapy to restore mobility.
• Splinting to support wrist extension.
• Medical therapy such as NSAIDs for pain relief.

Surgical Treatment

• Nerve repair or grafting in severe cases.
• Decompression surgery if entrapment is identified.