The spiral groove (radial groove) is a shallow oblique groove on the posterior surface of the humeral shaft running from superomedial to inferolateral, housing the radial nerve and the profunda brachii artery as they wind around the humerus from the posterior compartment of the upper arm to the anterior compartment of the forearm. The groove is bounded by the lateral and medial heads of triceps.
The spiral groove is the site of radial nerve palsy in mid-humeral shaft fractures, prolonged external pressure (Saturday night palsy from sleeping with the arm over a chair back), and tourniquet injuries. The term Holstein-Lewis fracture specifically describes the spiral or short oblique mid-shaft fracture that traps the radial nerve in the groove. The nerve is exposed surgically by splitting the triceps and identifying the groove on the posterior humerus, used for nerve repair and for radial nerve decompression in persistent palsy.
Prolonged external pressure on the posterior humerus in the spiral groove from sleeping with the arm over a chair back or bench (alcohol or drug-induced prolonged positioning) compresses the radial nerve, producing neuropraxia with wrist drop and dorsal hand numbness that resolves within 6-8 weeks without surgery.
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