Wrist drop: Difference between revisions

Jump to navigation Jump to search
No edit summary
m (Robot: Changing Category:Diseases to Category:Disease)
Line 54: Line 54:
{{Diseases of the musculoskeletal system and connective tissue}}
{{Diseases of the musculoskeletal system and connective tissue}}
{{SIB}}
{{SIB}}
[[es:Parálisis del nervio radial]]


[[Category:Diseases]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
 
[[Category:Disease]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[Category:Overview complete]]
[[Category:Overview complete]]
[[es:Parálisis del nervio radial]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Revision as of 20:14, 12 December 2011

For patient information, click here

Wrist drop
Radial Nerve Palsy: Note inability of patient to extend right wrist.
(Image courtesy of Charlie Goldberg, M.D.)
ICD-10 M21.3
ICD-9 736.05

WikiDoc Resources for Wrist drop

Articles

Most recent articles on Wrist drop

Most cited articles on Wrist drop

Review articles on Wrist drop

Articles on Wrist drop in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Wrist drop

Images of Wrist drop

Photos of Wrist drop

Podcasts & MP3s on Wrist drop

Videos on Wrist drop

Evidence Based Medicine

Cochrane Collaboration on Wrist drop

Bandolier on Wrist drop

TRIP on Wrist drop

Clinical Trials

Ongoing Trials on Wrist drop at Clinical Trials.gov

Trial results on Wrist drop

Clinical Trials on Wrist drop at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Wrist drop

NICE Guidance on Wrist drop

NHS PRODIGY Guidance

FDA on Wrist drop

CDC on Wrist drop

Books

Books on Wrist drop

News

Wrist drop in the news

Be alerted to news on Wrist drop

News trends on Wrist drop

Commentary

Blogs on Wrist drop

Definitions

Definitions of Wrist drop

Patient Resources / Community

Patient resources on Wrist drop

Discussion groups on Wrist drop

Patient Handouts on Wrist drop

Directions to Hospitals Treating Wrist drop

Risk calculators and risk factors for Wrist drop

Healthcare Provider Resources

Symptoms of Wrist drop

Causes & Risk Factors for Wrist drop

Diagnostic studies for Wrist drop

Treatment of Wrist drop

Continuing Medical Education (CME)

CME Programs on Wrist drop

International

Wrist drop en Espanol

Wrist drop en Francais

Business

Wrist drop in the Marketplace

Patents on Wrist drop

Experimental / Informatics

List of terms related to Wrist drop

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, also known as radial nerve palsy, is a condition where a person can not extend their wrist and it hangs flaccidly. To demonstrate wrist drop, hold your arm out in front of you with your forearm parallel to the floor. With the back of your hand facing the ceiling (i.e. pronated), let your hand hang limply so that your fingers point downward. A person with wrist drop would be unable to move from this position to one in which the fingers are pointing up towards the ceiling.

Anatomy of the forearm

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).

Differential diagnosis of causes of wrist drop

Wrist extension is achieved by muscles in the forearm contracting, pulling on tendons that attach distal to (beyond) the wrist. If the tendons, the muscles, or the nerves supplying these muscles, are not working as they should be, wrist drop may occur. The following situations may result in wrist drop:

Stab wounds to the chest at or below the clavicle may result in wrist drop. The radial nerve is the terminal branch of the posterior cord of the brachial plexus. A stab wound may damage the posterior cord and result in neurological deficeits including an inability to abduct the shoulder beyond 15 degrees, an inability to extend the forearm, reduced ability to supinate the hand, reduced ability to abduct the thumb and sensory loss to the posterior surface of the arm and hand.

The radial nerve can be damaged if the humerus (the bone of the arm) is broken, because it runs through the radial groove on the lateral border of this bone.

Wrist drop is also associated with lead poisoning because of the effect of lead on the radial nerve.[1]

Persistent injury to the nerve is also a common cause through either repetitive motion or by applying pressure externally along the route of the radial nerve as in the prolonged use of crutches or extended leaning on the elbows.

Diagnosis

The workup for wrist drop frequently includes nerve conduction velocity studies to isolate and confirm the radial nerve as the source of the problem. Plain films can help identify bone spurs and fractures that may have injured the nerve. Sometimes MRI imaging is required to differentiate subtle causes.

Treatment

Initial management includes splinting of the wrist for support along with occupational or physical therapy. In some cases surgical removal of bone spurs or other anatomical defects that may be impinging on the nerve might be warranted.

See also

References

  1. Dedeken P, Louw V, Vandooren AK, Geert V, Goossens W, Dubois B (2006). "Plumbism or lead intoxication mimicking an abdominal tumor". Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine. 21 (6): C1–3. doi:10.1111/j.1525-1497.2006.00328.x. PMID 16808730.

Template:Diseases of the musculoskeletal system and connective tissue Template:SIB


Template:WikiDoc Sources