I have had wrist drop for 19 days after an injury, with normal finger flexion and pinch and ongoing rehabilitation; will my radial nerve recover and restore wrist extension?

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Radial Nerve Recovery After 19 Days of Wrist Drop

You have an excellent prognosis for complete recovery of your radial nerve function and wrist extension, particularly given your preserved finger flexion and pinch strength at 19 days post-injury.

Expected Recovery Timeline

Your clinical presentation strongly suggests neuropraxia (temporary nerve dysfunction without structural damage), which typically recovers within 2-12 weeks:

  • Initial improvement typically begins at 2-3 weeks post-injury, with most patients showing signs of recovery by this timeframe 1
  • Complete recovery occurs in the majority of cases within 3-4 months of consistent rehabilitation 2, 1
  • The fact that you maintain normal finger flexion and pinch indicates your median and ulnar nerves are intact, which is a favorable prognostic sign 3

Why Your Prognosis is Good

Several factors predict excellent recovery in your case:

  • Preserved distal function: Your ability to flex fingers and perform pinch movements indicates the injury is isolated to the radial nerve and likely incomplete 3
  • Early rehabilitation: You've already initiated functional electrical stimulation (FES) and rehabilitation within the critical first 6 months window 4
  • Typical recovery pattern: Most compressive radial neuropathies show improvement beginning at a mean of 2.4 weeks, with progressive recovery thereafter 1

Critical Rehabilitation Strategy

Continue your FES therapy aggressively - the American Heart Association specifically recommends FES for wrist motor impairment within the first 6 months post-injury, as it produces improved muscle force in wrist extension and increases motor strength and control 4. This serves as crucial adjunctive therapy during your recovery period.

What to Monitor

Watch for these positive signs of recovery:

  • Gradual return of wrist extension strength - even minimal movement is encouraging 2
  • Improved sensation over the dorsum of your hand between the thumb and index finger 1
  • Reduced need for wrist splinting as extensor power returns 2

Important Caveat

If you show no improvement by 8-12 weeks, electrodiagnostic studies (nerve conduction studies and EMG) should be performed to assess for more severe nerve injury requiring surgical exploration 3, 1. However, given your current clinical picture with preserved distal function, this scenario is unlikely.

The overwhelming majority of patients with your presentation achieve complete recovery with continued rehabilitation and time 2, 1.

References

2
Research

Blood pressure cuff compression injury of the radial nerve.

Journal of clinical anesthesia, 2001

3
Research

Radial neuropathy.

Handbook of clinical neurology, 2024

4
Guideline

Radial Nerve Injury Recovery Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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