Is the radial groove a myth? Is the radial nerve in direct contact with the posterior humerus?

• Published in: Surgical and radiologic anatomy (English ed.) 2023-05, Vol.45 (5), p.581-586
• Main Authors: Qawasmi, Feras, Dasari, Suhas P., Safadi, Hazem, Yari, Shahram S., Grindel, Steven I.
• Format: Article
• Language: English
• Subjects: Anatomy; Cadaver; Cadavers; Chi-square test; Data collection; Dissection; Histological Techniques; Humans; Humerus; Humerus - innervation; Imaging; Medicine; Medicine & Public Health; Muscle, Skeletal - innervation; Original Article; Orthopedics; Periosteum; Radial Nerve - anatomy & histology; Radiology; Surgery; Triceps brachii muscle
• ISSN: 1279-8517; 0930-1038; 1279-8517
• DOI: 10.1007/s00276-023-03134-7

Background The radial groove is known as a sulcus on the posterior humerus and protects the radial nerve from adjacent muscle and soft tissue. In the literature, there exists heterogeneity regarding the presence of an actual radial groove and the radial nerve’s interaction with the periosteum of the humerus. This study aimed to determine if there is a real radial groove, “sulcus,” and define the relationship between the radial nerve and the periosteum of the posterior humerus. Methods Eighteen fresh-frozen cadaveric specimens were dissected using a posterior triceps splitting approach. The radial nerve’s interaction with the periosteum of the humerus was determined. The presence of a visible and palpable radial groove was also examined. Results In 56% of specimens, the radial nerve was directly seated over the periosteum of the posterior humerus (direct contact between the nerve and bone). In comparison, 44% of specimens had a layer of the medial head of the triceps brachii muscle fibers interposition between the nerve and bone. 89% of specimens had no visible or palpable radial groove. In 11% of specimens, there was mild palpable depression. Conclusion This study shows that the radial groove may not exist and is probably not a true anatomical structure. In addition, the nerve is in direct contact with the posterior periosteum of the humerus in most specimens. These anatomic relationships and findings add to the anatomical understanding of the radial nerve, which helps during operative approaches and fixation of the humerus.