The supinator fossa is the lateral elbow space between the extensor muscles and the radial neck, through which the posterior interosseous nerve passes within the radial tunnel and enters the supinator. This space is the surgical territory for posterior interosseous nerve decompression and radial tunnel release.
The supinator fossa is accessed via the Kocher interval between the ECRB and EDC for lateral elbow surgery, or between the brachioradialis and ECRL for the Henry approach to the proximal radius. The posterior interosseous nerve traverses this space and is at risk during lateral elbow approaches. Four compression sites within the radial tunnel in this fossa are systematically released during surgical decompression.
Posterior interosseous nerve compression within the supinator fossa at one or more of the four potential compression sites, producing lateral elbow aching without wrist drop, managed by radial tunnel surgical release.
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