Morphological classification, anatomical variations, innervation patterns, musculocutaneous nerve relation of the coracobrachialis muscle: anatomical study and clinical significance.

Abstract

The anatomical variations of coracobrachialis muscle (CBM) are of great clinical importance. This study aimed to elucidate the morphological variations, innervation patterns and musculocutaneous nerve (MCN) relation to CBM. Upper limbs of fifty cadavers (30 males and 20 females) were examined for proximal and distal attachments, innervation pattern of CBM and its relation to MCN. Four morphological types of CBM were identified according to number of its heads. The commonest type was the two-headed (63.0%) followed by the single belly (22.0%), three-headed (12.0%) and lastly fourheaded (3.0%) type. Moreover, an abnormal insertion of CBM was observed in four left limbs (4.0%); one inserting into the medial humeral epicondyle, the second into the upper third of humeral shaft, the third one in the common tendon of biceps, and the fourth one showing a bifurcated insertion. Also, four different innervation patterns of CBM were identified including MCN (80.0%), lateral cord (14.0%), lateral root of median nerve (4.0%), and median nerve itself (2.0%). The course of MCN was superficial to the single belly CBM (19.0%) and in-between the heads in the other types (71.0%). Measurements of the length and original distance of CBM muscular branches originating from MCN revealed no sex or side significant difference. Awareness of the anatomic variations, innervation patterns, and MCN relation of CBM is imperative in recent diagnostic and surgical procedures to obtain definite diagnosis, effective management and good outcome.