The lateral supracondylar ridge is the lateral bony ridge running from the lateral epicondyle proximally along the lateral humerus. It provides the origin of the brachioradialis and extensor carpi radialis longus muscles, which arise from its distal portion. The radial nerve descends anterior to the lateral supracondylar ridge before dividing into its superficial and deep (posterior interosseous) branches.
The lateral supracondylar ridge is the reference for the lateral approach to the distal humerus and for localising the brachioradialis muscle belly as a landmark for the radial nerve in the antecubital fossa. Radial nerve palsy at this level from humeral shaft fractures (Holstein-Lewis fracture at the lateral supracondylar ridge) produces wrist drop and finger extension weakness. Tapping the radial nerve on the anterior surface of the lateral ridge (Tinel sign) indicates nerve regeneration during recovery.
The Holstein-Lewis humeral shaft fracture at the distal third-lateral supracondylar ridge junction traps the radial nerve against the bone, producing complete radial nerve palsy with wrist drop; spontaneous recovery occurs in most cases within 3-4 months, with surgical exploration reserved for no recovery or nerve transaction.
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