Wrist drop

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Wrist , ( radial nerve or muskulospiral nerve palsy , and colloquial as parral crutch , Saturday night palsy or honeymoon palsy) , is a medical condition in which the wrist and fingers can not extend the metacarpophalangeal joint. The wrist remains partially flexed because of the opposite action of the flexor muscles of the forearm. As a result, the extensor muscles in the posterior compartment remain paralyzed.

Video Wrist drop

Anatomy forearms

The forearm is a body part that extends from the elbow to the wrist and does not become confused with the arm, which extends from the shoulder to the elbow. Extensor muscles in the forearm are extensor carpi ulnaris, extensor digiti minimi, extensor digitorum, extensor indicis, extensor carpi radialis brevis, and extensor carpi radialis longus. These extensor muscles are supplied by the posterior interosseous nerve, the branch of the radial nerve. Other muscles in the forearm that are innervated by the radial nerve are supinator, extensor pollicis brevis, extensor pollicis longus and abductor pollicis longus. All of these muscles are located in the posterior half of the forearm (posterior when in a standard anatomical position). Also, brachioradialis, anconeus, tricep brachii and extensor carpi radialis longus are all innervated by the branches of the radial nerve muscles in the arms.

Maps Wrist drop

Cause

Wrist extension is achieved by the muscles in the contracting forearm, drawing the tendon attached to the distal (outside) part of the wrist. If the tendons, muscles, or nerves that supply these muscles are damaged or are not working properly, a decrease in the wrist may occur.

The following situations may cause a decrease in the wrist:

• Stab wounds to the chest at or below the clavicle-The radial nerve is the terminal branch of the posterior plexus of the brachial plexus. Stab wounds can damage the cord and result in neurological deficits, including an inability to remove the shoulder beyond the first 15 degrees, the inability to extend the forearm, reduce the ability to reach out, reduce the ability to extract the thumb and loss of the senses. to the posterior surface of the arm and hand.
• Humerus Fracture-Radial nerves can be damaged if the humerus (arm bone) is broken as it travels through a radial groove on the lateral border of this bone along with a deep brachial artery.
• Lead poisoning-The wrist is associated with lead poisoning because of the effect of lead on the radial nerve.
• Persistent injury - Persistent injury to the nerve is a common cause either through repetitive motion or by applying external pressure along the radial nerve route as in long-term use of crutches or extended leaning on the elbow. The daily term for radial nerve paralysis comes from this cause.
• Correcting the dislocated shoulders-Palial radial nerves can result from the now discredited practice of correcting the dislocated shoulders by placing the legs in the armpits of the person and pulling the arm in an attempt to shift the humerus back into the glenoid cavity of the scapula.
• Neuropathy in the hands and/or arms in patients with rheumatoid arthritis may be in rare cases causing a decrease in the wrist. "When the joint swells up, it can pinch the nerve of the sensation that passes through it.If the swelling disturbs the nerves, either because of inflammation or simply from pressure, the nerves can send pain, numbness and/or tingling sensations to the brain. often occurs on the wrist (carpal tunnel syndrome) and elbow (ulnar nerve trap).A rare form of neurological disease in patients with rheumatoid arthritis that causes numbness and/or tingling is neuropathy.Neuropathy is a nerve damage that in people with rheumatoid arthritis can occur due to inflammation of blood vessels (vasculitis). "

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Type

The type of wrist decrease is differentiated by the affected nerve:

• Brakiioradialis weakness, wrist extension and finger flexion = radial nerve lesion
• Weakness of finger extension and radial wrist irregularities in extension = posterior interosseous lesion
• Triceps weakness, extensor finger and flexor = c7,8 lesions
• Common weakness of the upper limb is marked by deltoid, tricep, wrist extension and finger extension = corticospinal lesion

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Diagnosis

Examination for wrist reduction often involves the study of the speed of nerve conduction to isolate and confirm the radial nerves as the source of the problem. Other screening tests include the inability to extend the thumb into a "hitchhiker sign". Plain film can help identify bone spurs and fractures that may have injured nerves. Sometimes MRI imaging is needed to distinguish subtle causes.

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Treatment

Initial care includes splinting the wrist for support, along with osteopathic treatment, physiotherapy and occupational therapy. In some cases, surgical removal of bone spurs or other anatomical abnormalities that may affect the nerve may be necessary. If the injury is the result of pressure from long-term use of improperly crutches or other similar mechanisms of injury, then the wrist loss symptoms are likely to disappear spontaneously within 8-12 weeks.

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See also

• Radial neuropathy

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References

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External links

• clinical consideration at The Anatomy Lesson by Wesley Norman (Georgetown University)
• William C. Shiel Jr., MD, FACP, FACR. "Rheumatoid Arthritis: 17 Warning Signs of Serious Complications". Ã, CS1 maint: Many names: list of authors (links)

Source of the article : Wikipedia