Only finger drop and no wrist drop in Posterior interosseus nerve injury, is due to sparing of
## **Core Concept**
The posterior interosseous nerve (PIN) is a branch of the radial nerve that supplies muscles in the forearm, primarily responsible for wrist and finger extension. Injury to the PIN can lead to a condition known as "finger drop" without "wrist drop" because some wrist extensors are spared.
## **Why the Correct Answer is Right**
The correct answer involves understanding the innervation of the forearm muscles. The PIN innervates muscles that are responsible for finger extension (extensor digitorum, extensor indicis, and extensor digiti minimi) and thumb extension (extensor pollicis longus). However, the extensor carpi radialis longus and brevis, which are responsible for wrist extension, are innervated by the radial nerve before the PIN branch. Therefore, in a PIN injury, wrist extension is partially spared due to these muscles still being functional, but finger extension is significantly impaired, leading to finger drop without wrist drop.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is incorrect because it does not accurately represent the muscle or nerve supply relevant to the sparing of wrist extension in PIN injury.
- **Option B:** This option is incorrect because, although the supinator muscle is innervated by the PIN, its sparing does not directly explain the preservation of wrist extension.
- **Option C:** The extensor carpi radialis brevis is one of the muscles responsible for wrist extension and is innervated by the radial nerve before the PIN branch, making it a correct reason for sparing of wrist extension in PIN injury.
- **Option D:** This option is incorrect as it does not accurately relate to the specific scenario of PIN injury and sparing of wrist extension.
## **Clinical Pearl / High-Yield Fact**
A key clinical point to remember is that in posterior interosseous nerve palsy, wrist drop is not observed because the radial nerve's branches to the extensor carpi radialis longus and brevis, which control wrist extension, are proximal to the PIN branch. This results in the ability to extend the wrist, albeit sometimes with a radial deviation due to the preserved action of extensor carpi radialis longus.
## **Correct Answer:** C. extensor carpi radialis brevis.