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Wrist extension is achieved by muscles in the forearm contracting, pulling on tendons that attach distal to (beyond) the wrist. If the tendons, the muscles, or the nerves supplying these muscles, are not working as they should be, wrist drop may occur.

The extensor muscles in the forearm are supplied by the radial nerve. The radial nerve can be damaged if the humerus (the bone in the upper arm) is broken, because it runs through a groove on this bone.

Wrist drop is also associated with lead poisoning because of the effect of lead on the radial nerve.