Lesions of the radial nerve occur most commonly in this region. The lesions are usually due to displaced fractures of the humeral shaft after inebriated sleep, during which the arm is allowed to hang off the bed or bench ("Saturday night palsy"), during general anesthesia, or from callus formation due to an old humeral fracture. There may be a familial history, or underlying diseases such as alcoholism, lead and arsenic poisoning, diabetes mellitus, polyarteritis nodosa, serum sickness, or advanced Parkinsonism.
The clinical findings are usually similar to those of an axillary lesion, except that: a) the triceps muscle and the triceps reflex are normal; b) sensibility on the extensor aspect of the arm is normal, whereas that of the forearm may or may not be spared, depending on the site of origin of this nerve from the radial nerve proper.
Lesions distal to the spiral groove and above the elbow—just prior to the bifurcation of the radial nerve and distal to the origin of the bra-chioradialis and extensor carpi radialis longus—produce symptoms similar to those seen with a spiral groove lesion, with the following exceptions: a) the triceps reflex is normal; b) the brachioradialis and extensor carpi radialis longus muscles are spared.
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