Absence of the Musculocutaneous Nerve While Performing Nerve Transfer Surgery in a Patient with Brachial Plexus Injury, Rare Variant, and Review of Literature

Abstract

Musculocutaneous nerve (MCN) is among the nerves of the anterior compartment of the arm, and it is a mixed nerve derived from the lateral cord of the brachial plexus. Here, in this study, the patient had avulsion of the upper roots of the brachial plexus and was prepared to undergo nerve transfer surgery to innervate the MCN to restore elbow fl exion; its absence was a surprise and a challenge at the same time. This study aims to describe a rare variant of MCN (absence). This is a case report. A 41-year-old male patient had a brachial plexus injury after a road traf fi c accident. He presented with loss of elbow fl exion and prepared for performing neurotization of the MCN. The surgical intervention was performed under general anesthesia without using neuromuscular blocking agents, and the absence of the MCN was noted. Knowledge of the MCN variant is essential, especially if it is the target nerve of surgical intervention.