Wrist drop occurs as a consequence of
radial nerve palsy. From the estimates, it is found that each
person receives at least two
injections annually in the
developing countries, and 50 percent of these
injections are not considered safe.(1) Unfortunately,
trauma to
peripheral nerves isn't unusual in our country. Though reliable
statistics are not available at the national level, the
incidence of
injury to
peripheral nerves, especially to
radial nerve, is on the rise, largely due to increased road
traffic accidents and increased
violence in our society as a whole.(1)
Radial Nerve damage occurring as a consequence of
intramuscular injection application is comparatively less common than
sciatic nerve injury.(2) When
therapeutic and prophylactic agents are applied in the form of
intramuscular injections into
buttock and
arm, occasionally damage to the
peripheral nerves can occur. Those whose
radial nerve function has been compromised would not be able to actively extend extensor
muscles of the
wrist and digits since the
radial nerve innervates them. As a result, the
hand hangs flaccidly in a flexed position when the
patient attempts to move the
arm to a horizontal position.
Patients may also experience paraesthesia,
hypoesthesia,
numbness and other sensory disturbances. Simple,
pain-free sensory deficits may be functionally less significant because they involve the anatomical snuffbox and the radial dorsum of the
hand.
Injury to
radial nerve results in motor function impairment leading to weakness during extension of the
forearm,
wrist, and
fingers. However,
wrist extension may be relatively spared because common
radial nerve innervates the extensor carpi radialis longus
muscle proximal to its division.(3)The inability of a
person to extend his
wrist and/or
fingers due to the above mentioned causes is called "wrist drop" or "
finger drop."(4) The other causes of wrist drop include
stab wound injury to
shoulder area where the terminal branch of posterior cord of
brachial plexus is given off as
radial nerve and any agent causing persistent
injury to nerve. Interventions for wrist drop include splinting,
electrical stimulation,
exercises for
hand and
fingers,
surgery, and
drug therapy. The present case is diagnosed with Wrist Drop caused due to the
injection induced
injury to the
radial nerve of left side.
Needle length recommendation is very important before inducing the
injection in
male and
female.(4)In the
developing countries, common
diseases are treated with the application of
injections. When
therapeutic and prophylactic agents are applied in the form of
intramuscular injections into
buttock and
arm, occasionally damage to the
peripheral nerves can occur. There are various reasons for the
injury to the
peripheral nerves. In case of wrist drop, reasons for the
injury to the
radial nerve may be gun-shot
injury, humeral shaft fracture, misplaced
injection and compression or
ischemia