Danger zone of radial nerve in Indian population - A cadaveric study

Identification of the radial nerve is necessary during surgery of the humerus fracture to avoid injury to it. Iatrogenic nerve injury during humerus fracture surgery is a well-known complication. Prevention of this type of injuries would be of great value. Aim of this study is to reduce the chance of iatrogenic nerve injury by defining of a danger zone in the distal upper arm regarding the radial nerve in indian population.

Thirty six upper limbs of eighteen adult human formalin preserved cadavers (14 males & 4 females) were used in this study. The posterior aspect of the arm was dissected to expose the radial nerve from the triangular space to the point where the radial nerve pierced the lateral intermuscular septum. Systematic identification of radial nerve and multiple measurements were done for each specimen.

The mean humeral length was 30.96 + 1.23 cm. Mean Distance of medial epicondyle to entry of radial nerve into spiral groove was 18.5 + 0.79 cm. Mean Distance of lateral epicondyle to exit of radial nerve into spiral groove was 11.34 + 0.41 cm. The mean length of radial nerve groove/spiral groove was 4.3 + 0.75 cm.

Our study has identified the point of intersection of radial nerve to humerus in Indian population. Understanding the safe zones and the zone of danger of the humerus provides more safety during the surgical interference of the humerus. To do this, the radial nerve must be identified and protected. Wide incision and blunt dissection is still recommended to minimize the risk of radial nerve damage.