Abstract
Purpose
Radial nerve is closely in contact with the bone in sulcus nervi radialis (SNR). Location of SNR shows ethnic differences. Radial nerve is a big problem in humerus fractures and its surgery. In this study, we aimed to examine if humerus fractures of this region increases the probability of radial nerve injury.
Methods
Total length of humerus and the distance of SNR to proximal and distal anatomical points were measured on 57 human dry cadaver bones. The mean values of these data were calculated. The 58 cases of treated humerus fractures in our orthopedics department, whose radiological film techniques were available, were involved in the study and their measurements were made at the same anatomic reference points, retrospectively. Proximal and distal safe zones to total length ratios of both groups were determined. The ratios of the cases were compared with the confidence intervals of dry bones. Location of the fracture line according to SNR and the relationship between radial nerve injury and this location were evaluated.
Results
Sulcus nervi radialis region was located at the middle of humerus. Of 24 cases which had radial nerve injury, only nine cases had fracture of SNR region. Of the 34 cases which had no radial nerve injury, 16 had fracture of SNR region.
Conclusions
As a result; radial nerve injury rate was 37.5% for the fractures of SNR region and it was higher compared to other studies. We concluded that the fractures of SNR region do not increase the risk of radial nerve injury.
Similar content being viewed by others
References
Artico M, Telera S, Tiengo C et al (2008) Surgical anatomy of the radial nerve at the elbow. Surg Radiol Anat. doi:10.1007/s00276-008-0412-8
Ay S, Tekdemir I, Sayli U et al (1999) Relation of the radial nerve with the sulcus nervi radialis: a morphometric study. Okajimas Folia Anat Jpn 76(4):197–202
Bleeker WA, Nijsten MW, ten Duis HJ (1991) Treatments of humeral shaft fractures related to associated injuries. A retrospective study of 237 patients. Acta Orthop Scand 62:148–153
Bono CM, Grossman MG, Hochwald N et al (2000) Radial and axillary nerves. Clin Orthop and Relat Res 373:259–264
Chou PH, Shyu JF, Ma HL et al (2008) Courses of the radial nerve differ between Chinese and Caucasians: clinical applications. Clin Orthop Relat Res 466(1):135–138
Cognet JM, Fabre T, Durandeau A (2002) Persistent radial palsy after humeral shaft fracture: cause, treatment, and results in operated patients. Rev Chir Orthop Reparatrice Appar Mot 88:655–662
Ekholm R, Adami J, Tidermark J et al (2006) Fractures of the shaft of the humerus. An epidemiological study of 401 fractures. J Bone Joint Surg Br 88(11):1469–1473
Fleming P, Lenehan B, Sankar R et al (2004) One-third, two-thirds: Relationship of the radial nerve to the lateral intermuscular septum in the arm. Clin Anat 17:26–29
Guse TR, Ostrum RF (1995) The surgical anatomy of the radial nerve around the humerus. Clin Orthop and Relat Res 320:149–153
Houwelingen AV, McKee MD (2004) Management and complications of humeral shaft fractures. Orthopedics 81(2):96–102
Kleinert JM, Mehta S (1996) Radial nerve entrapment. Orthop Clin North Am 27(2):305–315
Larsen LB, Barfred T (2000) Radial nerve palsy after simple fracture of the humerus. Scand J Plast Reconstr Surg Hand Surg 34:363–366
Ring D, Chin K, Jupiter JB (2004) Radial nerve palsy associated with high-energy humeral shaft fractures. J Hand Surg [Am] 29(1):144–147
Shah JJ, Bhatti NA (1983) Radial nerve paralysis associated with fractures of the humerus. Clin Orthop and Relat Res 172:171–176
Shao YC, Harwood P, Grotz MR et al (2005) Radial nerve palsy associated with fractures of the shaft of the humerus: a systematic review. J Bone Joint Surg Br 87(12):1647–1652
Snell RS (1992) Clinical Anatomy for Medical Students, 4th edn. Little Brown and Company, Toronto, p 546
Standring SM (2005) Gray’s Anatomy, 39th edn. Elsevier, Edinburg, pp 824–857
Thomsen NOB, Dahlin LB (2007) Injury to the radial nerve caused by fracture of the humeral shaft: Timing and neurobiological aspects related to treatment and diagnosis. Scand J Plast Reconstr Surg Hand Surg 41:153–157
Van Sint Jan S, Nguyen Van D, Rooze M (2008) Quantified relationship of the radial nerve with the radial groove and selected humeral landmarks. Surg Radiol Anat. doi:10.1007/s00276-008-0388-4
Whitson RO (1954) Relation of the radial nerve to the shaft of the humerus. J Bone Joint Surg Am 36(1):85–88
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ozden, H., Demir, A., Guven, G. et al. The relation of sulcus nervi radialis with the fracture line of humerus fracture and radial nerve injury. Surg Radiol Anat 31, 283–287 (2009). https://doi.org/10.1007/s00276-008-0444-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-008-0444-0