Wrist drop overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Wrist drop is a condition where a person can not extend their wrist and it hangs flaccidly.
Anatomy
In anatomical parlance, the forearm is the part of the body which extends from the elbow to the wrist and is not to be confused with the arm which extends from the shoulder to the elbow. The extensor muscles in the forearm are extensor carpi ulnaris, extensor digiti minimi, extensor digitorum, extensor indicis, extensor pollicis longus, extensor pollicis brevis, extensor carpi radialis brevis, extensor carpi radialis longus. These extensor muscles are supplied by the radial nerve. Other muscles in the forearm also innervated by the radial nerve are brachioradialis, supinator and abductor pollicis longus. Note that all these muscles are situated in the posterior half of the forearm (posterior when in the anatomical position).
Diagnosis
X Ray
Plain films can help identify bone spurs and fractures that may have injured the nerve.
MRI
Sometimes MRI imaging is required to differentiate subtle causes.
Other Diagnostic Studies
The workup for wrist drop frequently includes nerve conduction velocity studies to isolate and confirm the radial nerve as the source of the problem.
Treatment
Medical Therapy
The goal of treatment is to allow you to use the hand and arm as much as possible. The health care provider should find and treat the cause, if possible. In some cases, no treatment is needed and you will recover slowly on your own. Initial management includes splinting of the wrist for support along with occupational or physical therapy. Medical causes such as diabetes and kidney disease should be treated.
Surgery
In some cases surgical removal of bone spurs or other anatomical defects that may be impinging on the nerve might be warranted.
Prevention
Avoid prolonged pressure on the upper arm.