RADIAL NERVE INJURIES;

PRESENTING AS WRIST DROP-ANALYSIS OF 100 PATIENTS

Abstract

Objective: To highlight etiological factors leading to radial nerve injury resulting in wrist drop, with
particular reference to iatrogenic causes. Design: Retrospection & Descriptive. Material & Methods: One hundred
patients of all ages and both sexes with wrist drop. Data of clinical assessment after detailed history and examination
as well as electro diagnostic studies was recorded on pre-designed assessment proforma. The outcome was charted
down for frequency of etiology of the wrist drop. Setting: Rehabilitation Medicine Department of Combined Military
Hospital (CMH) Multan and Armed Forces Institute of Rehabilitation Medicine (AFIRM). Results: The major cause of
injury was splinter/gun shot injury 31%, mis-placed injection at mid-arm 21%fracture of humerus was 21%, compression
neuropathy 16%, and stab wound 11%caused wrist drop. Electro-physiological studies revealed that 85% patients had
injury to radial nerve at mid-arm, 9% had injury to posterior interosseous nerve while 4% had injury to superficial branch
of radial nerve and only 2% had normal study. Electrodiagnostic studies also revealed that majority of the patients
suffered from axonotmesis (44%) and neurapraxia (38%), whereas (16%) were neurotmesis. Conclusion: The most
common cause of radial nerve injury is trauma. It is also found that the frequency of radial nerve palsy due to iatrogenic
causes is quite high. In addition to the clinical examination, the nerve conduction studies and electromyography proved
to be the better investigation technique in the assessment of the location, severity and extent of the peripheral nerve
injury and subsequently guides in starting the proper treatment option due to early referral of patient to the concerned
fields.