Anatomical considerations of subcoracoid neurovascular structures in anterior shoulder reconstruction

Tom, James A.; Cerynik, Douglas L.; Lee, C Marcus; Lewullis, Gabriel E.; Kumar, Neil S.

doi:10.1002/ca.21025

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…Over-retraction of the conjoint tendon is avoided to prevent injury to the musculocutaneous nerve which occurs as proximal as 3.8 cm from the tip of the coracoid process. The anterior circumflex vessels that cross the surgical field along the lower aspect of the subscapularis tendon are ligated or coagulated [ 25 ].…”

Section: Surgical Considerationsmentioning

confidence: 99%

Anatomic Shoulder Arthroplasty: Technical Considerations

Matache

Lapner

2017

TOORTHJ

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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.

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Section: Surgical Considerationsmentioning

confidence: 99%

Anatomic Shoulder Arthroplasty: Technical Considerations

Matache

Lapner

2017

TOORTHJ

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“…Several procedures include the muscles' mobilization attached into the CP, mainly for treating the anterior shoulder instability [6, 12,27], and the CB transfer in reconstructive surgery [13,16]. The MCN may be injured also in the commonly used shoulder surgery anterior deltopectoral approach [19,30].…”

Section: Introductionmentioning

confidence: 99%

Coracobrachialis muscle morphology and coexisted neural variants. A cadaveric case series

Piagkou

Tsakotos

Triantafyllou

et al. 2023

Preprint

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Purpose The current cadaveric case series evaluates and reports the morphology of the coracobrachialis muscle (CB), and the related musculocutaneous nerve (MCN) origin, course, and branching pattern, as well as associated adjacent muscular and neural variants. Materials and Methods Twenty-seven formalin embalmed cadaveric arms (24 paired from 12 cadavers and 3 unpaired), were dissected to identify the CB possible variants with emphasis on the MCN course and coexisted neural variants. Results Four morphological types of the CB were found: a two-headed 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 CB variant morphology was identified in 37.04% (10/27). A three-headed biceps brachii coexisted in 23.53% (4/17). Two different MCN courses were recorded: a course between CB superficial and deep heads (in cases of two or more CB heads) (100%, 24/24), and a medial course in case of one-headed CB (100%, 3/3). The interconnection of the lateral cord with the median nerve median root was identified in 18.52%, the MCN with the median nerve in 7.41% and of the radial with the ulnar nerve in 3.71%. Duplication of the median nerve lateral root was identified in 11.1%. Conclusions The knowledge of the morphology of the muscles of the anterior arm compartment, especially CB variant morphology and the related MCN variable course, is of paramount importance for surgeons. Careful dissection and knowledge of relatively common variants play a significant role in reducing iatrogenic injury.

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Coracobrachialis muscle morphology and coexisted neural variants: a cadaveric case series

et al. 2023

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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.

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Anatomical considerations of subcoracoid neurovascular structures in anterior shoulder reconstruction

Cited by 4 publications

References 19 publications

Anatomic Shoulder Arthroplasty: Technical Considerations

Anatomic Shoulder Arthroplasty: Technical Considerations

Coracobrachialis muscle morphology and coexisted neural variants. A cadaveric case series

Coracobrachialis muscle morphology and coexisted neural variants: a cadaveric case series

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