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Predictors of Radial Nerve Position on the Humerus: An MRI-based Anatomical Study
Olivia Wang, MD; Christopher Aranda, BS; Nicholas Gonsalves, BS; Vincent Moretti, MD; Alfonso Mejia, MD
University of Illinois at Chicago, Chicago, IL

The radial nerve traverses the posterior aspect of the humeral shaft as it moves distally on the upper extremity. Awareness of this anatomy is crucial to posterior surgical approaches to the humerus for trauma, and the nerve may also be injured in trauma, such as Holstein-Lewis fractures. Prior cadaveric studies noted the position of the radial nerve 14 cm and 20 cm from the lateral and medial condyles, respectively. In this study, 16 MRI studies of the arm were reviewed to identify the position of the radial nerve and possible predictor variables such as gender, height, humerus length and humerus intercondylar width.
The mean distance of the radial nerve to the distal trans-epicondylar humeral line both lateral and posterior to the humeral shaft was 11.1 cm (7.9-14.3 cm, 95% confidence interval) and 16.3 cm (11.9-20.8 cm, 95% CI). A positive linear correlation was observed for both patient height and humeral length, as well as radial nerve distance from the epicondyles. Males (mean height 1.72m) had greater humeral lengths, humeral widths and radial nerve distance than females (mean height 1.54m). Males showed a larger lateral and posterior humeral nerve distance of 12.3 and 17.3cm (12.9-21.9cm and 9.9-14.6cm, 95%CI) compared to 10.2 and 15.8cm (11.8-19.6cm and 5.4-14.9cm, 95%CI) in females, respectively. A small positive correlation was seen between humeral length and epicondylar humeral width.
The radial nerve distance from point of crossover medial to lateral within the spiral groove on the humeral shaft appears to increase with patient height, humeral length, and gender.


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