1
|
Piagkou M, Tsakotos G, Triantafyllou G, Koutserimpas C, Chytas D, Karampelias V, Pantekidis I, Triantafyllou A, Natsis K. Coracobrachialis muscle morphology and coexisted neural variants: a cadaveric case series. Surg Radiol Anat 2023; 45:1117-1124. [PMID: 37464221 PMCID: PMC10514118 DOI: 10.1007/s00276-023-03207-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE The current cadaveric case series evaluates the coracobrachialis muscle morphology, the related musculocutaneous nerve origin, course, and branching pattern, as well as associated adjacent neuromuscular variants. MATERIALS AND METHODS Twenty-seven (24 paired and 3 unpaired) cadaveric arms were dissected to identify the coracobrachialis possible variants with emphasis on the musculocutaneous nerve course and coexisted neural variants. RESULTS Four morphological types of the coracobrachialis were identified: a two-headed muscle in 62.96% (17/27 arms), a three-headed in 22.2% (6/27), a one-headed in 11.1% (3/27), and a four-headed in 3.7% (1 arm). A coracobrachialis variant morphology was identified in 37.04% (10/27). A three-headed biceps brachii muscle coexisted in 23.53% (4/17). Two different courses of the musculocutaneous nerve were recorded: 1. a course between coracobrachialis superficial and deep heads (in cases of two or more heads) (100%, 24/24), and 2. a medial course in case of one-headed coracobrachialis (100%, 3/3). Three neural interconnections were found: 1. the lateral cord of the brachial plexus with the medial root of the median nerve in 18.52%, 2. the musculocutaneous with the median nerve in 7.41% and 3. the radial with the ulnar nerve in 3.71%. Duplication of the lateral root of the median nerve was identified in 11.1%. CONCLUSIONS The knowledge of the morphology of the muscles of the anterior arm compartment, especially the coracobrachialis variant morphology and the related musculocutaneous nerve variable course, is of paramount importance for surgeons. Careful dissection and knowledge of relatively common variants play a significant role in reducing iatrogenic injury.
Collapse
Affiliation(s)
- Maria Piagkou
- Department of Anatomy, School of Medicine, Faculty of Health, and Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527, Athens, Greece.
| | - George Tsakotos
- Department of Anatomy, School of Medicine, Faculty of Health, and Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527, Athens, Greece
| | - George Triantafyllou
- Department of Anatomy, School of Medicine, Faculty of Health, and Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527, Athens, Greece
| | - Christos Koutserimpas
- Department of Orthopaedics and Traumatology, "251" Hellenic Air Force General Hospital of Athens, Athens, Greece
| | - Dimitrios Chytas
- Basic Sciences Laboratory, Department of Physiotherapy, University of Peloponnese, Sparta, Greece
- European University Cyprus, Engomi, Nicosia, Cyprus
| | - Vasilios Karampelias
- Department of Anatomy, School of Medicine, Faculty of Health, and Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527, Athens, Greece
| | - Ioannis Pantekidis
- Department of Anatomy, School of Medicine, Faculty of Health, and Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527, Athens, Greece
| | - Anastasia Triantafyllou
- Department of Anatomy, School of Medicine, Faculty of Health, and Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527, Athens, Greece
| | - Konstantinos Natsis
- Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health and Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
2
|
Matache BA, Lapner P. Anatomic Shoulder Arthroplasty: Technical Considerations. Open Orthop J 2017; 11:1115-1125. [PMID: 29152006 PMCID: PMC5676003 DOI: 10.2174/1874325001711011115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/09/2017] [Accepted: 05/14/2017] [Indexed: 11/22/2022] Open
Abstract
Osteoarthritis of the shoulder is a common condition in the aging population, and it can have profound effects on patients’ quality of life. The anatomic total shoulder arthroplasty is a well-described treatment modality resulting generally excellent outcomes. The objective of this review is to discuss the technical aspects of primary anatomic total shoulder arthroplasty, and to provide a framework to follow to achieve a successful surgical result. The topics covered include preoperative planning, surgical considerations, and approaches, humeral preparation, glenoid bone loss and the emerging concept of using the reverse total shoulder arthroplasty for the type B2 glenoid.
Collapse
Affiliation(s)
- Bogdan A Matache
- Orthopaedic Surgery Resident, Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - P Lapner
- Associate Professor of Surgery, Division of Orthopaedic Surgery, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| |
Collapse
|