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Document Type

Original Article

Abstract

Background and Objective:

Radial neuropathy is a common cause of wrist drop, and accurate lesion localization is essential for appropriate

management and prognostication. The objective of this study was to analyze electrophysiological localization patterns

of radial nerve lesions presenting as wrist drop and to assess whether earlier referral for electrophysiological evaluation

was associated with recovery outcomes.

Methods:

This retrospective observational study was conducted at Lady Reading Hospital Peshawar, a tertiary care setting, over

a three-year period (January 2022–December 2024). Adult patients with wrist drop and electrophysiological confirmed

radial neuropathy were included. Nerve conduction studies and needle electromyography were used to classify lesions

as high radial nerve palsy, posterior interosseous nerve (PIN) syndrome, or radial tunnel syndrome. Functional recovery

at ≥3 months was categorized as complete, partial, or none. Outcomes were compared between early (≤4 weeks)

and delayed (>4 weeks) electrophysiological evaluation. Data was analyze using SPSS version 25.0.

Results:

Fifty-four patients were analyzed (mean age 42.3 ± 15.2 years; 70.4% male). High radial nerve palsy was the most

common lesion (61.1%), followed by PIN syndrome (29.6%) and radial tunnel syndrome (9.3%). Compression was the

leading etiology. Complete recovery was significantly more frequent in patients undergoing early electrophysiological

evaluation compared with delayed assessment (76.0% vs. 44.8%; p = 0.03).

Conclusion:

Early EMG testing itself does not directly improve nerve recovery. Instead, earlier electrophysiological referral may

facilitate timely diagnosis and management, which could contribute to improved functional outcomes.

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