Expected Recovery Timeline for Closed Radial Nerve Injury with Wrist Drop
Full recovery of wrist extension typically requires 3–6 months of continuous splinting and therapy, not just a few weeks, even though your preserved flexor function and occasional paresthesia indicate a favorable prognosis for complete functional restoration. 1
Why Your Clinical Findings Are Encouraging
Your intact flexor function at this stage is an excellent prognostic sign—it confirms an isolated radial nerve injury rather than a more serious central nervous system lesion or brachial plexus injury. 1 The presence of occasional paresthesia suggests that sensory nerve fibers are beginning to regenerate, which typically precedes motor recovery. 2
Realistic Recovery Timeline
Motor recovery generally takes 3–6 months from the time of injury, requiring sustained splinting and physical therapy throughout this entire period—not just the initial few weeks. 1
With traumatic radial nerve lesions like yours, the prognosis for recovery is generally good, with most patients achieving substantial functional improvement. 2
Recovery follows a predictable pattern: sensory symptoms (like your paresthesia) often improve first, followed by gradual return of motor function starting proximally and progressing distally. 3
Critical Management Requirements During Recovery
Mandatory Splinting Protocol
You must wear a wrist splint in neutral or slight extension 24 hours per day (removing only for therapy sessions) to prevent wrist-drop contracture while your nerve regenerates. 1
Do not discontinue splinting prematurely—sustained splint use for several months is essential to prevent permanent contracture, even as motor function begins to return. 1
Essential Physical Therapy Components
Perform daily passive stretching of wrist and finger extensors to maintain soft-tissue length and prevent shortening during the denervation period. 1
Conduct 30 minutes of wrist positioning in maximal extension each day while seated or supine to promote optimal alignment. 1
As motor function returns, implement neuromuscular re-education focused on movement quality rather than pure strength to restore coordinated wrist and finger extension. 1
Imaging You Should Obtain Now
Get plain radiographs of your entire forearm and elbow immediately to exclude occult fractures or bony lesions that could be compressing your radial nerve—these can be present even without remembered trauma. 1
If radiographs are normal, proceed with non-contrast MRI to assess for nerve compression, soft-tissue masses, or intrinsic nerve injury that might require surgical intervention. 1
Red Flags Requiring Urgent Referral
Progressive numbness or weakness despite ongoing therapy should prompt immediate referral to hand surgery or neurology. 1
MRI evidence of a compressive mass or discontinuity of the radial nerve warrants urgent surgical evaluation. 1
If no motor recovery is evident by 3–5 months post-injury, exploration and potential nerve reconstruction should be considered. 4
Common Pitfalls to Avoid
The most critical mistake patients make is discontinuing their splint once they notice early signs of recovery—this leads to contracture formation that can permanently limit function even after the nerve fully regenerates. 1 Equally important is not delaying imaging, as early detection of compressive lesions is critical for timely management. 1 Physical therapy alone is insufficient; splinting is equally vital to protect the joint and support nerve recovery. 1