What are the features of radial nerve (RN) palsy?

Radial nerve palsy presents with characteristic features including wrist drop, inability to extend the fingers at the metacarpophalangeal joints, and weakness in thumb extension and abduction. Patients typically cannot extend their wrist against gravity, resulting in the classic "wrist drop" appearance. Sensory deficits may occur over the posterior forearm and the dorsal aspect of the hand, particularly affecting the web space between the thumb and index finger. Patients often report difficulty with fine motor tasks like writing, turning doorknobs, or grasping objects. The condition can be classified as high (affecting the triceps), middle (affecting wrist and finger extensors), or low (affecting only the finger extensors). Common causes include compression during sleep (Saturday night palsy), humeral fractures, compression from improper crutch use, or prolonged pressure on the upper arm. Treatment depends on the cause, with conservative management including wrist splinting, physical therapy, and nerve gliding exercises for mild cases. Surgical exploration may be necessary for severe cases or those without improvement after 3-4 months. Recovery can take weeks to months depending on the severity of nerve damage, with proximal injuries generally having a poorer prognosis than distal ones.