Akademik Veri Yönetim Sistemi
TURKIYE KLINIKLERI TIP BILIMLERI DERGISI, cilt.29, sa.2, ss.464-468, 2009 (SCI-Expanded)
Objective: One of the preferred approaches to maintain the arm and forearm function after musculocutaneous nerve (MN) injury is neurotization. The aim of the present study was to expose the branches of the NM and to evaluate the length of its branches which are all particularly important for neurotization as well as to discuss the clinical relevance of our findings. Material and Methods: This study was conducted on 32 upper extremities of 16 fixed adult cadavers. The distance between the anteromedial angle of the coracoid process (AACP) and the points where the nerve gave off its branches was measured and the length of all the motor branches was recorded. Then the anatomical branch pattern of the nerve and the number of the motor branches innervating each muscle was noted. Results: The MN was observed to dive into the coracobrachialis in 30 cases (93.8%) and course medially to coracobrachialis in 6.2%. The first motor branch of the MN was observed to innervate the coracobrachialis and the distance between its branching point and AACP was measured 7.5 +/- 1.6 cm. The second branch was determined to innervate the short head of biceps brachii in 71.9% of the cases and the distance between its branching point and the AACP was measured 12.7 +/- 1.7 cm. In 28.1% of the cases the second branch was observed to be a common trunk innervating both heads of biceps brachii. The distance between the origin of this branch and the AACP was measured 14 +/- 1.5 cm. The last motor branch of the MN was observed to innervatebrachialis and the distance between the origin of this branch and the AACP was measured 18.6 +/- 3.1 cm. Conclusion: Loss of elbow flexion following brachial plexus injury is a major functional deficit and should be reconstructed. The exact knowledge of the branching pattern, branch length and fascicular arrangement of the MN and the donor nerve is necessary for successful surgical management. We suggest that the findings of the present study will guide the surgeons dealing with MN repair.