wrist drop.pptx

Describes the radial nerve palsy

1. Wr i s t d r o p Gr o u p 3 2022

2. o u t l i n e In t r o d u c t i o n R isk factors P at h oanatomy S igns and symptoms D iferrenial diagnosis D iagnosis T reatment compications.

3. In t r o d u c t i o n A w r i st drop refers to the inability to actively extend the hand at the wrist. I ts due to w e a k n e s s o f t h e w r i s t e x t e n s o r s , n a m e l y e x t e n s o r c a r p i r a d i a l l i s l o n g u s, e xtensor car p i r a d i a l i s b r e vis and extensor carpi ulnaris muscles, all innervated by the radial n e r v e o r i t s b r a n c h e s. I ts usually due to a peripheral neuropathy affecting the radial nerve.

4. Pathoanatomy Wr i s t d rop is a disorder caused by radial nerve pals y . B e c a u s e o f the radial nerves innervation o f t h e e x t e n s o r m u s c l e s o f t h e w r i s t a n d d i g i t s, t h o s e w h o s e r a d i a l nerve function has been compromised cannot actively extend them. A s such, the ha n d h a n g s f l a c c i d l y i n a p o s i t i o n o f f l e x i o n w h e n t h e p a t i e n t a t t e m p t s to bring the arm to a h o r i zontal position.

5. Ri s k f a c t o r s Gender: Radial nerve palsy is more common in men than women. Occupational risks: Jobs that require repetitive motion and awkward postures or working positions may increase the risk of radial nerve palsy. Other injuries: f r a c t u r e m i d s h a f t h u m e r u s , r adius # s, joint dislocations, significant bruises and injuries requiring the use of crutches can increase a person’s risk for radial nerve palsy.

6. Si g n s and sympto m s Numbness from the triceps down to the fingers Problems extending the wrist or fingers Pinching and grasping problems Weakness or inability to control muscles from the triceps down to the fingers Wrist drop – when the wrist hangs limply and the patient cannot lift it

7. Di a g n o s i s a n d i n v e s t i g a t i o n s To diagnose radial nerve palsy, a physician will perform a physical examination to evaluate weakness, numbness and other symptoms in the arm and hand. Electromyogram (EMG): This test measures the electrical activity of a muscle in response to stimulation, as well as the nature and speed of the conduction of electrical impulses along a nerve. It can confirm the presence of nerve damage and assess its severity. Imaging studies: The physician may order an X-ray, ultrasound or MRI to check for broken bones, cysts and other masses in the arm. Nerve conduction studies: These tests measure how well individual nerves can send an electrical signal from the spinal cord to the muscles. A physician places a shock-emitting electrode directly over the nerve to be studied, and a recording electrode over the muscles supplied by that nerve. The shock-emitting electrode sends repeated, brief electrical pulses to the nerve, and the recording electrode records the time it takes for the muscle to contract in response to the electrical pulse

8. Treatment This condition may go away over time as accompanying injuries heal, cysts or tumors are removed, or awkward postures are corrected. But, some people may always experience varying degrees of radial nerve palsy. Treatment and Recovery Treatment of radial nerve palsy may include: Medication Your physician may recommend prescription or over-the-counter medication to decrease pain associated with radial nerve palsy. Physical Therapy Y our physician or physical therapist may prescribe exercises to strengthen your muscles and increase your range of motion. Splint or Cast A splint or cast can support the wrist and hand while the radial nerve heals.

9. C o n t i n u a t i o n ........... Surgery In certain cases, your physician may recommend surgery to remove a cyst, tumor or broken bone pressing on the nerve or repair the nerve itself. Transcutaneous Electrical Nerve Stimulation (TENS) This therapy applies a gentle electric current to the muscles and may help reduce pain. Recovery Recovery time depends on how badly the radial nerve was damaged. It may take weeks to months for a nerve to heal after treatment

10. Co m p lications P artial or compl t e l o s s o f f e e l i n g i n t h e h a n d P artial or complet e l o s s o f w r i st or hand movement M ild to sev e r e d e f o r m i t i e s o f t h e h a n d e g s t i f f n e s s , w r i s t d r o p R ecurrent or unnoticed injuries to the wrist or hand

11. E N D Th a n k y o u f o r y o u r a t t e n t i o n