Management of Radial Nerve Lesion with Wrist Drop

Immediate Orthotic Management

• The American Academy of Orthopaedic Surgeons recommends applying a dorsal cock-up splint that positions the wrist in 20-30 degrees of extension to facilitate functional hand use 1, 2
• The splint should be padded and comfortably tight but not constrictive, according to Praxis Medical Insights 2

Critical Early Motion Protocol

• Active finger motion exercises must be performed from diagnosis to prevent finger stiffness, which is one of the most functionally disabling adverse effects, as recommended by the American Academy of Orthopaedic Surgeons 1, 2
• Finger motion does not adversely affect the injury and provides significant impact on patient outcome, with evidence from the American Academy of Orthopaedic Surgeons 1, 2
• Hand stiffness can be very difficult to treat after it develops, requiring multiple therapy visits and possibly surgical intervention, as noted by the American Academy of Orthopaedic Surgeons 1, 2
• All unaffected joints should maintain full active range of motion throughout the treatment period, according to Praxis Medical Insights 2

Common Pitfalls to Avoid

• Rigid immobilization of fingers leads to unnecessary stiffness and poor functional outcomes, as warned by Praxis Medical Insights 2
• The splint should only stabilize the wrist, not restrict finger motion, as recommended by the American Academy of Orthopaedic Surgeons and Praxis Medical Insights 1, 2