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Anatomy of the axillary arch: from its incidence in human to an embryologic and a phylogenetic explanation of its origins

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Abstract

Introduction

Typically, the axillary arch is defined as a fleshy slip running from latissimus dorsi to the anterior aspect of the humerus. Phylogeny seems to give the most relevant and plausible explanation of this anatomical variant as a remnant of the panniculus carnosus. However, authors are not unanimous about its origin. We report herein the incidence of axillary arch in a series of 40 human female dissections and present an embryologic and a comparative study in three domestic mammals.

Materials and methods

Forty formalin-preserved Caucasian human female cadavers, one rat (Rattus norvegicus), one rabbit (Oryctolagus cuniculus) and one pig (Sus scrofa domesticus) cadavers were dissected bilaterally. A comparative, analytical and a descriptive studies of serial human embryological sections were carried out.

Results

We found an incidence of axillary arch of 2.5% (n = 1 subject of 40) in Humans. We found a panniculus carnosus inserted on the anterior aspect of the humerus only in the rat and the rabbit but not in the pig. The development of the latissimus dorsi takes place between Carnegie stage 16–23, but the embryological study failed to explain the genesis of the axillary arch variation. However, comparative anatomy argues in favour of a panniculus carnosus origin of the axillary arch.

Conclusions

With an incidence of 2.5% of cases, the axillary arch is a relatively frequent variant that should be known by clinician and especially surgeons. Moreover, while embryology seems to fail to explain the genesis of this variation, comparative study gives additional arguments which suggest a possible origin from the panniculus carnosus.

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Acknowledgements

We are grateful to the donors of the Institute of Anatomy and Organogenesis of Lille and their families without whom anatomical studies for medical research advancements and education of future healthcare providers would not be possible. We thank Maurice De Meulaere, Fabien Descamps and Franck Stevendart from the Institute of Anatomy and Organogenesis of Lille for their assistance throughout the dissections. We thank Martin Fourdrinier and Arnold Dives from the department of animal experimentations of Lille University for their assistance throughout the dissections. We also thank Dr R. John Cork for permission to use images from the Virtual Human Embryo project (available at https://virtualhumanembryo.lsuhsc.edu).

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Authors and Affiliations

  1. Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, 20 rue Leblanc, 75908, Paris Cedex 15, France

    Martin Lhuaire, Ignacio Garrido, Vincent Hunsinger, Mohamed Derder & Laurent Lantieri

  2. Institute of Anatomy, URDIA, EA4465, UFR Biomédicale des Saints-Pères, Université de Paris, Paris, France

    Martin Lhuaire & Vincent Delmas

  3. Department of General and Digestive Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France

    Martin Lhuaire, Daniele Sommacale & Reza Kianmanesh

  4. Department of Gynecology and Oncology Surgery, Institut Jean Godinot, Université de Reims Champagne-Ardenne, Reims, France

    Karl Wehbe

  5. Department of Gynecologic and Breast Oncologic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, Paris, France

    Vincent Balaya

  6. Institute of Anatomy and Clinical Education, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK

    Peter Abrahams

  7. Faculté de Médecine Henri Warembourg, Institute of Anatomy and Organogenesis, Université de Lille, Lille, France

    Christian Fontaine

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  1. Martin Lhuaire
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Contributions

All persons listed as authors have contributed substantially to the design, performance, analysis and reporting of this work. ML, KW, IG, VH, MD, VB: collected data, analyzed data, wrote paper. VD, PH, DS, RK: analyzed data, wrote paper. ML, LL, CF: Designed study, analyzed data, wrote paper.

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Correspondence to Martin Lhuaire.

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Lhuaire, M., Wehbe, K., Garrido, I. et al. Anatomy of the axillary arch: from its incidence in human to an embryologic and a phylogenetic explanation of its origins. Surg Radiol Anat 43, 619–630 (2021). https://doi.org/10.1007/s00276-020-02605-5

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