Abstract
Variations of the brachialis muscle are uncommon in the literature. During regular cadaveric dissection, we observed the unilateral presence of an accessory muscle in the front of the right arm of a female cadaver, taking its origin from the medial aspect of the brachialis and the adjacent intermuscular septum. The muscle belly descended downwards, crossed the neurovascular bundle in the cubital fossa and merged with the fibres of the pronator teres. There is no doubt regarding its significance in the etiogenesis of numerous compression syndromes due to its close topographical relationship with the neurovascular bundle. In our report, we consider the potential developmental process and therapeutic implications of this variation, which can aid surgeons in their strategy and management.
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References
Jawed AM, Fatima N, Kumar S, Kumar B, Kumar V (2017) An accessory brachialis muscle associated with abnormal arrangement of structures in the cubital fossa. Int J Res Med Sci 3(12):3907–3910. https://doi.org/10.18203/2320-6012.ijrms20151469
Arey, Leslie Brainerd. Developmental Anatomy: A Textbook and Laboratory Manual of Embryology. Philadelphia: W. B. Saunders Company, 1946. 616 p. - Science Education - Wiley Online Library.” Retrieved April 26, 2022 (https://doi.org/10.1002/sce.3730320162).
Bertelli JA, Ghizoni MF (2006) Brachialis muscle transfer to reconstruct finger flexion or wrist extension in brachial plexus palsy. J Hand Surg 31(2):190–196. https://doi.org/10.1016/j.jhsa.2005.09.020
Chuang YM, Luo CB, Chou YH, Cheng YC, Chang CY, Chiou HJ (2002) Sonographic diagnosis and treatment of a median nerve epineural hematoma caused by brachial artery catheterization. J Ultrasound Med 21(6):705–708. https://doi.org/10.7863/jum.2002.21.6.705
Flory PJ, Berger A (1985) The accessory brachial tendon–a rare cause of pronator teres syndrome. Handchirurgie, Mikrochirurgie Plastische Chirurgie Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse Organ Der 17(5):270–272
Frazer EA, Hobson M, McDonald SW (2007) The distribution of the radial and musculocutaneous nerves in the brachialis muscle. Clin Anat 20(7):785–789. https://doi.org/10.1002/ca.20521
Krishnamurthy A, David SJ, Bagoji IB, Nayak SR, Pai MM (2010) Accessory brachialis muscle associated with high division of brachial artery. Int J Anat Var 3:160
Loukas M, Louis RG, South G, Alsheik E, Christopherson C (2006) A Case of an accessory brachialis muscle. Clin Anat 19(6):550–553. https://doi.org/10.1002/ca.20285
Mehta V, Yadav Y, Jyoti Arora H, Kumar RK, Suri, and G. Rath. (2009) Clinico-embryological perspective of a rare accessory brachial muscle with possible musculocutaneous nerve compression. Morphologie 93(300):27–29. https://doi.org/10.1016/j.morpho.2009.03.001
Nakatani T, Tanaka S, Mizukami S (1998) Bilateral four-headed biceps brachii muscles: the median nerve and brachial artery passing through a tunnel formed by a muscle slip from the accessory head. Clin Anat 11(3):209–212
Nelluri V, Swamy RS, Nayak SB, Kumar N, Patil J (2016) Bulky accessory brachialis muscle with abnormal aponeurosis: a case report. Proceed Singap Healthc 25(4):249–251. https://doi.org/10.1177/2010105816641698
Pai MM, Nayak SR, Vadgaonkar R, Ranade AV, Prabhu LV, Thomas M, Sugavasi R (2008) Accessory brachialis muscle: A case report. Morphologie 92(296):47–49
Paraskevas G, Natsis K, Ioannidis O, Papaziogas B, Kitsoulis P, Spanidou S (2008) Accessory muscles in the lower part of the anterior compartment of the arm that may entrap neurovascular elements. Clin Anat 21(3):246–251. https://doi.org/10.1002/ca.20608
Sirisinagandla S, Potu B (2013) Clinical and functional significance of accessory brachialis muscle: an unique anatomical variant. Int J Morphol 31:1383–1385. https://doi.org/10.4067/S0717-95022013000400037
Standring S. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 40th ed. Edinburgh: Elsevier Churchill Livingstone: 2011.p.541–3.”
Vadgaonkar R, Rai R, Ranade AV, Nayak SR, Pai MM, Lakshmi R (2008) A case report on accessory brachialis muscle. Rom J Morphol Embryol 49(4):581–583
Acknowledgements
The authors wish to express their gratitude to the families of all those who selflessly donated the bodies of their relatives for medical education and research. We also would like to acknowledge the help of attenders of department of Anatomy, AIIMS Bibinagar, Hyderabad for their efforts in maintaining the cadaveric laboratory.
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Conceptualization: AK, RM; methodology: AK, RM; data collection: RM, AK; analysis and interpretation of results: RM, AK; writing—original draft: RM, AK; writing—review and editing: RM, AK, MC; critical revision of the manuscript: RM, AK, MC; approval of the final version of the manuscript: all authors—RM, AK, MC.
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Kaliappan, A., Motwani, R. & Chandrupatla, M. Unilateral accessory brachialis muscle and its functional significance: a case report of rare variation. Surg Radiol Anat 45, 11–15 (2023). https://doi.org/10.1007/s00276-022-03053-z
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DOI: https://doi.org/10.1007/s00276-022-03053-z