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Wrist drop
Loss of radial nerve function in the hand creates a significant disability
Patient can not extend the fingers and thumb and therefore has great difficulty in
grasping objects.
Loss of active wrist extension robs grasp and power grip
• The radial nerve is the largest branch of the brachial
plexus
• Continuation of the posterior cord, with nerve fibers
from C6, C7, C8, and,occasionally, T1.
• The radial nerve innervates the extensor and
supinator musculature located in the arm
and forearm and provides distal sensation.
Course
• Passes across the LD deep to the axillary artery.
• Winds around the medial side of the humerus,
• And enters the triceps muscle between the long and
medial heads.
• It follows the spiral groove of the humerus, piercing the
lateral intermuscular septum (10 cm proximal to the
lateral epicondyle) from posterior to anterior,
• Runs between the brachialis and brachioradialis to lie
anterior to the lateral condyle of the humerus.
• The nerve then divides into a superficial branch and
a deep branch.
• The superficial branch, purelysensory,
• Runs under cover of the brachioradialis in the forearm.
• Innervates the radial wrist, dorsal radial hand, and
dorsum of the radial digits
cousre
• The deep branch of the radial nerve, the posterior interosseous
nerve,
• winds to the dorsum of the forearm,
• around the lateral side of the radius,
• and through the muscle fibers of the supinator.
Motor supply
All extensor muscles:
1. Abductor pollicis longus
1. Extensor pollicis brevis
2. Extensor carpi radialis longus
3. Extensor carpi radialis brevis
4. Extensor pollicis longus
5. Extensor digitorum communis
6. Extensor indicis proprius
7. Extensor digiti minimi qui
8. Extensor carpi ulnaris
Motor supply
sumeryadav2004@gmail.com
• Triceps (long, medial,
lateral)
• Anconeus
• Brachioradialis
• Supinator
Lower lateral cutaneous
nerve of arm
Posterior cutaneous
nerve of arm
Posterior cutaneous
nerve of forearm
Dorsal radial sensory
nerve
Gives sensibility to the
dorsum of the hand over the
radial two-thirds, the dorsum
of the thumb, and the index,
middle finger proximal to the
distal interphalangeal joint.
Cutaneous innervation from radial nerve
 sharp or burning pain
 Numbness or tingling
 Trouble straightening the arm
 Trouble moving the wrist and fingers
 Drooping of wrist and fingers
 Weakness in hand grip
symptoms
• ROM of wrist ( to check any weakness or loss of muscle
tone)
• X-ray ,CT scan and MRI
• Electromyography
• Nerve conduction test
Diagnosis
Depend upon underlying cause:-
 Analgesic or anti inflammatory medication
 Steroid injection
 Splints or braces
 Physiotherapy
Wrist drop

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Wrist drop

  • 2. Loss of radial nerve function in the hand creates a significant disability Patient can not extend the fingers and thumb and therefore has great difficulty in grasping objects. Loss of active wrist extension robs grasp and power grip
  • 3.
  • 4. • The radial nerve is the largest branch of the brachial plexus • Continuation of the posterior cord, with nerve fibers from C6, C7, C8, and,occasionally, T1. • The radial nerve innervates the extensor and supinator musculature located in the arm and forearm and provides distal sensation.
  • 5. Course • Passes across the LD deep to the axillary artery. • Winds around the medial side of the humerus, • And enters the triceps muscle between the long and medial heads. • It follows the spiral groove of the humerus, piercing the lateral intermuscular septum (10 cm proximal to the lateral epicondyle) from posterior to anterior, • Runs between the brachialis and brachioradialis to lie anterior to the lateral condyle of the humerus. • The nerve then divides into a superficial branch and a deep branch. • The superficial branch, purelysensory, • Runs under cover of the brachioradialis in the forearm. • Innervates the radial wrist, dorsal radial hand, and dorsum of the radial digits
  • 6. cousre • The deep branch of the radial nerve, the posterior interosseous nerve, • winds to the dorsum of the forearm, • around the lateral side of the radius, • and through the muscle fibers of the supinator.
  • 7. Motor supply All extensor muscles: 1. Abductor pollicis longus 1. Extensor pollicis brevis 2. Extensor carpi radialis longus 3. Extensor carpi radialis brevis 4. Extensor pollicis longus 5. Extensor digitorum communis 6. Extensor indicis proprius 7. Extensor digiti minimi qui 8. Extensor carpi ulnaris
  • 8. Motor supply sumeryadav2004@gmail.com • Triceps (long, medial, lateral) • Anconeus • Brachioradialis • Supinator
  • 9. Lower lateral cutaneous nerve of arm Posterior cutaneous nerve of arm Posterior cutaneous nerve of forearm Dorsal radial sensory nerve Gives sensibility to the dorsum of the hand over the radial two-thirds, the dorsum of the thumb, and the index, middle finger proximal to the distal interphalangeal joint. Cutaneous innervation from radial nerve
  • 10.
  • 11.
  • 12.  sharp or burning pain  Numbness or tingling  Trouble straightening the arm  Trouble moving the wrist and fingers  Drooping of wrist and fingers  Weakness in hand grip symptoms
  • 13. • ROM of wrist ( to check any weakness or loss of muscle tone) • X-ray ,CT scan and MRI • Electromyography • Nerve conduction test Diagnosis
  • 14. Depend upon underlying cause:-  Analgesic or anti inflammatory medication  Steroid injection  Splints or braces  Physiotherapy