From the Guidelines
Yes, radial nerve palsy can cause wrist drop, as it is the classic and most recognizable manifestation of radial nerve injury, characterized by the inability to extend the wrist and fingers at the metacarpophalangeal joints. When the radial nerve is damaged, patients lose control of the extensor muscles in the forearm that are responsible for lifting the wrist and fingers. This results in the hand hanging limply in a flexed position when the arm is extended forward with the palm facing downward.
Causes and Treatment
Radial nerve palsy can occur from various causes including trauma (especially humeral fractures), compression (Saturday night palsy from pressure during deep sleep), lead poisoning, or iatrogenic injury during surgery. Treatment depends on the underlying cause and may include:
- Splinting to prevent contractures
- Physical therapy to maintain range of motion
- Addressing the primary cause In cases of compression, symptoms often resolve once the compression is relieved, while more severe injuries may require surgical intervention. Recovery time varies from weeks to months depending on the severity of nerve damage.
Rehabilitation
According to the guidelines for adult stroke rehabilitation and recovery 1, various interventions such as constraint-induced movement therapy (CIMT), bilateral upper limb training, robotic therapy, and mental practice may be beneficial for upper extremity motor rehabilitation. However, the effectiveness of these interventions may vary depending on the individual patient and the severity of their condition.
Key Points
- Radial nerve palsy can cause wrist drop due to damage to the radial nerve
- Treatment depends on the underlying cause and may include splinting, physical therapy, and addressing the primary cause
- Recovery time varies from weeks to months depending on the severity of nerve damage
- Various rehabilitation interventions may be beneficial for upper extremity motor rehabilitation, but their effectiveness may vary depending on the individual patient and condition.
From the Research
Radial Nerve Palsy and Wrist Drop
- Radial nerve palsy can cause severe functional impairment due to paralysis of wrist and digit extensors, leading to wrist drop 2.
- Wrist drop is a common clinical presentation of radial nerve palsy, often accompanied by paresthesia on the dorsum of the 1st to 3rd fingers 3.
- Radial nerve injury or compression can result in axonal lesion, leading to wrist drop, as seen in cases of Saturday night palsy 4, 3, 5.
- The condition can be caused by various factors, including compressive injuries, prolonged compression against the spiral groove of the humerus, or underlying neuropathies 4, 3, 6.
- Clinical characteristics and diagnostic assessment methods, such as electrophysiologic evaluation, can help clinicians diagnose radial neuropathy and exclude irrelevant evaluations 3.
- Treatment and management of radial nerve palsy, including orthotic interventions, can improve functional status and grip strength, allowing patients to regain mobility and perform daily activities 2.