Will a 3-week post-injury patient with wrist drop, no motor function on the dorsal surface, but intact palmar movements and no sensory loss, and who has been following all rehabilitation treatments, recover from their condition?

Recovery Prognosis for Wrist Drop at 3 Weeks Post-Injury

Yes, you will likely recover, but the absence of any improvement at 3 weeks indicates you need to immediately add functional electrical stimulation (FES) to your current rehabilitation program—this specific intervention is strongly recommended for wrist motor impairment and has demonstrated restoration of voluntary wrist extension in patients like you. 1, 2

Why Your Prognosis is Favorable

Your clinical presentation contains several positive prognostic indicators that predict good recovery:

• Preserved palmar (flexor) function indicates the nerve injury is incomplete, which is associated with better recovery potential than complete nerve injuries 2, 3
• Intact sensation confirms no sensory nerve damage, eliminating a major complication that would worsen prognosis 1
• No inflammation or swelling suggests the injury is resolving rather than progressing, which is critical for neural recovery 3

The Critical Problem: You're Missing Essential Treatment

The lack of improvement at 3 weeks signals that passive rehabilitation alone is insufficient. Your current treatment protocol is incomplete without FES, which is specifically indicated for patients with wrist motor impairment and impaired muscle contraction. 1, 2

Why FES is Non-Negotiable for Your Case

• FES directly addresses wrist extensor weakness by electrically stimulating the paralyzed muscles to contract, preventing disuse atrophy while neural recovery occurs 1, 4
• Studies show 280% increase in wrist extension strength when FES is added to conventional therapy, compared to no significant change with conventional therapy alone 5
• FES must be combined with active task practice, not used as standalone treatment—apply stimulation during functional wrist extension activities for 30 minutes, 3 times daily 4, 2
• Treatment duration matters: patients in research studies received FES for 8-12 weeks to achieve maximal benefit, with improvements maintained at 32 weeks 4, 6

Your Complete Recovery Protocol

Immediate Addition: Functional Electrical Stimulation

• Apply FES to your wrist and forearm extensor muscles for 30 minutes, 3 times daily 4
• Use FES during active attempts at wrist extension, not during passive rest—the electrical stimulation should augment your voluntary effort 2, 7
• Continue FES therapy for at least 8 weeks to achieve meaningful strength gains and functional recovery 4, 6

Task-Specific Wrist Practice (Continue and Intensify)

• Begin with supported wrist movements on a table surface, then progress to unsupported movements as wrist control returns 2
• Practice functional activities requiring wrist extension with graded difficulty—start with light objects and progress to heavier resistance 2, 3
• Perform repetitive, goal-oriented activities that challenge wrist extension in multiple positions and contexts 2

Structured Resistance Training (Add When Voluntary Movement Returns)

• Start resistance training only after you regain some voluntary wrist extension, beginning with very low intensity at 40% of 1-repetition maximum for 10-15 repetitions 2, 3
• Progress to moderate intensity (41-60% of 1-RM) with 8-10 repetitions as strength improves 2
• Perform resistance training 2-3 times per week to allow adequate recovery between sessions 2, 3

Flexibility Work

• Perform static stretches of wrist flexors held for 10-30 seconds with 3-4 repetitions, 2-3 times per week to maintain range of motion 2, 3

Critical Management Principles: What NOT to Do

Avoid these common pitfalls that will delay or prevent your recovery:

• Do NOT use wrist splinting or immobilization—this prevents restoration of normal movement and promotes learned non-use of the recovering muscles 2, 3
• Do NOT rely on passive range of motion alone—active motor practice with FES is essential for neural recovery 2, 3
• Do NOT position your wrist at end ranges for prolonged periods, as this exacerbates symptoms and impedes recovery 2, 3

Expected Recovery Timeline

• Most motor recovery occurs within the first 6 months, making the next 3 months a critical window for intensive rehabilitation with FES 2, 3
• Rapid symptom relief typically occurs within 3-4 months with appropriate FES and structured rehabilitation 3
• Continue rehabilitation for 9-12 months for optimal functional recovery, even after wrist extension returns 2, 3
• Improvements in wrist strength are maintained at 32 weeks when FES is used for 8 weeks during the acute recovery phase 4

The Bottom Line on Your 3-Week Plateau

The absence of improvement at 3 weeks does not predict poor outcome—it indicates inadequate treatment intensity. 4, 5 Research demonstrates that patients with wrist drop who receive only conventional therapy show no significant strength gains, while those who add FES show dramatic improvements (280% increase in extension torque). 5 Your preserved finger function and intact sensation are positive prognostic indicators, but you must immediately add FES to your rehabilitation program to capitalize on the critical 6-month recovery window. 2, 3, 4