Skip to main content

Advertisement

SpringerLink
Log in

Proportional localisation of the entry point of the coracobrachialis muscle by the musculocutaneous nerve along the humerus

  • Original Article
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

To project the distance between the tip of the greater tubercle (GT), respectively, the proximal border of the tip of the coracoid process (CP) and the entry point of the coracobrachialis by the musculocutaneous nerve (MCN) proportionally onto the humeral length.

Methods

Sixty-six upper extremities were included in the study. The distance between the tip of the GT and the distal tip of the lateral humeral epicondyle (LE) was evaluated as the humeral length (HL). The interval between the tip of the GT and the entry point of the coracobrachialis muscle by the MCN was measured. The distance between the proximal border of the tip of the CP and the distal portion of the medial humeral epicondyle (ME) and the entry point of the MCN into the coracobrachialis were evaluated. Proportions were used to project the entry point of the coracobrachialis by the MCN along the HL, respectively, the interval between the proximal border of the tip of the CP and the distal tip of the ME.

Results

The entry point of the MCN into the coracobrachialis muscle can be expected at an interval between 14.9 and 33.9% of the HL (between the tip of the GT and the LE), starting from the tip of the GT. Regarding the reference line between the proximal border of the CP and the ME, the nerve’s entry point was located between 14.2 and 34.4%, starting from the CP.

Conclusion

Results represent easily applicable intervals for intraoperative localisation of the MCN.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ho E, Cofield RH, Balm MR, Hattrup SJ, Rowland CM. Neurologic complications of surgery for anterior shoulder instability. J Shoulder Elbow Surg. 1999;8:266–70.

    Article  CAS  PubMed  Google Scholar 

  2. Apaydin N, Bozkurt M, Sen T, et al. Effects of the adducted or abducted position of the arm on the course of the musculocutaneous nerve during anterior approaches to the shoulder. Surg Radiol Anat. 2008;30:355–60.

    Article  PubMed  Google Scholar 

  3. Macchi V, Tiengo C, Porzionato A, et al. Musculocutaneous nerve: histotopographic study and clinical implications. Clin Anat. 2007;20:400–6.

    Article  PubMed  Google Scholar 

  4. Singh H, Yang JS, Wiley T, et al. Relationship of the musculocutaneous nerve and its twigs to the coracoid process: an operative exposure. Orthop J Sports Med. 2020;8:2325967120954417.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Latarjet M. Technique de la butée coracóidienne pré-glénöidienne dans le traitement des luxations récidivantes de l’épaule [Technic of coracoid preglenoid arthroereisis in the treatment of recurrent dislocation of the shoulder]. Lyon Chir. 1958;54:604–7.

    CAS  PubMed  Google Scholar 

  6. Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy. 2000;16:677–94.

    Article  CAS  PubMed  Google Scholar 

  7. Cole BJ, L’Insalata J, Irrgang J, Warner JJ. Comparison of arthroscopic and open anterior shoulder stabilization a two to six-year follow-up study. J Bone Joint Surg Am. 2000;82:1108–4.

    Article  CAS  PubMed  Google Scholar 

  8. Kim SH, Ha KI, Kim SH. Bankart repair in traumatic anterior shoulder instability: open versus arthroscopic technique. Arthroscopy. 2002;18:755–63.

    Article  PubMed  Google Scholar 

  9. Sperber A, Hamberg P, Karlsson J, Swärd L, Wredmark T. Comparison of an arthroscopic and an open procedure for posttraumatic instability of the shoulder: a prospective, randomized multicenter study. J Shoulder Elbow Surg. 2001;10:105–8.

    Article  CAS  PubMed  Google Scholar 

  10. Levigne C. Résultats à long terme des butées antérieures coracoïdiennes A propos de 52 cas au recul homogène de 12 ans [Long-term results of anterior coracoid abutments: apropos of 52 cases with homogenous 12 year follow-up]. Rev Chir Orthop Reparatrice Appar Mot. 2000;86(1):114–21.

    PubMed  Google Scholar 

  11. Shah AA, Butler RB, Romanowski J, Goel D, Karadagli D, Warner JJ. Short-term complications of the Latarjet procedure. J Bone Joint Surg Am. 2012;94:495–01.

    Article  PubMed  Google Scholar 

  12. Griesser MJ, Harris JD, McCoy BW, Hussain WM, Jones MH, Bishop JY, Miniaci A. Complications and re-operations after Bristow-Latarjet shoulder stabilization: a systematic review. J Shoulder Elbow Surg. 2013;22:286–92.

    Article  PubMed  Google Scholar 

  13. Lafosse L, Boyle S. Arthroscopic Latarjet procedure. J Shoulder Elbow Surg. 2010;19(2 Suppl):2–12.

    Article  PubMed  Google Scholar 

  14. Karnaugh RD, Sperling JW, Warren RF. Arthroscopic treatment of coracoid impingement. Arthroscopy. 2001;17:784–7.

    Article  CAS  PubMed  Google Scholar 

  15. Lo IK, Parten PM, Burkhart SS. Combined subcoracoid and subacromial impingement in association with anterosuperior rotator cuff tears: An arthroscopic approach. Arthroscopy. 2003;19:1068–78.

    Article  PubMed  Google Scholar 

  16. Ruiz-Ibán MA, Murillo-González JA, Díaz-Heredia J, Avila-Lafuente JL, Cuéllar R. Pectoralis major transfer for subscapular deficiency: anatomical study of the relationship between the transferred muscle and the musculocutaneous nerve. Knee Surg Sports Traumatol Arthrosc. 2013;21:2177–83.

    Article  PubMed  Google Scholar 

  17. Lo IK, Burkhart SS, Parten PM. Surgery about the coracoid: neurovascular structures at risk. Arthroscopy. 2004;20:591–5.

    Article  PubMed  Google Scholar 

  18. Pan WJ, Teo YS, Chang HC, Chong KC, Karim SA. The relationship of the lateral cord of the brachial plexus to the coracoid process during arthroscopic coracoid surgery: a dynamic cadaveric study. Am J Sports Med. 2008;36:1998–001.

    Article  PubMed  Google Scholar 

  19. Clavert P, Lutz JC, Wolfram-Gabel R, Kempf JF, Kahn JL. Relationships of the musculocutaneous nerve and the coracobrachialis during coracoid abutment procedure (Latarjet procedure). Surg Radiol Anat. 2009;31:49–53.

    Article  PubMed  Google Scholar 

  20. Rebouças F, Filho RB, Filardis C, Pereira RR, Cardoso AA. Anatomical study of the musculocutaneous nerve in relation to the coracoid process. Rev Bras Ortop. 2015;45:400–3.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Thiel W. Ergänzung für die Konservierung ganzer Leichen nach W. Thiel [Supplement to the conservation of an entire cadaver according to W. Thiel]. Ann Anat. 2002;184:267–9.

    Article  PubMed  Google Scholar 

  22. Maier MJ. 2021 DirichletReg: Dirichlet Regression. R package version 0.7–1. https://cran.r-project.org/package=DirichletReg

  23. Maier MJ. 2014 DirichletReg: Dirichlet Regression for Compositional Data in R. Research Report Series/Department of Statistics and Mathematics, 125. WU Vienna University of Economics and Business, Vienna. https://epub.wu.ac.at/4077/

  24. Olewnik Ł, Zielinska N, Karauda P, Duparc F, Georgiev GP, Polguj M. The co-occurrence of a four-headed coracobrachialis muscle, split coracoid process and tunnel for the median and musculocutaneous nerves: the potential clinical relevance of a very rare variation. Surg Radiol Anat. 2021;43:661–9.

    Article  PubMed  Google Scholar 

  25. Crosado B, Löffler S, Ondruschka B, Zhang M, Zwirner J, Hammer N. Phenoxyethanol-based embalming for anatomy teaching: an 18 years’ experience with crosado embalming at the University of Otago in New Zealand. Anat Sci Educ. 2020;13:778–93.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

The authors did not receive support from any organization for the submitted work.

Author information

Authors and Affiliations

  1. AUVA-Rehabilitation Clinic Tobelbad, Tobelbad, Austria

    Renate Krassnig

  2. Department of Trauma Surgery, State Hospital Feldbach-Fürstenfeld, Ottokar-Kernstock-Straße 18, 8330, Feldbach, Austria

    Gloria Maria Hohenberger & Walter Prager

  3. AUVA-Trauma Hospital (UKH) Styria | Graz, Teaching Hospital of the Medical University of Graz, Graz, Austria

    Angelika Schwarz

  4. Department of Orthopaedics and Traumatology, Paracelsus Medical University, Salzburg, Austria

    Peter Grechenig

  5. Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Centre, Medical University of Graz, Graz, Austria

    Niels Hammer

  6. Division of Medical Technology, Fraunhofer Institute for Machine Tools and Forming Technology (Fraunhofer IWU), Dresden, Saxony, Germany

    Niels Hammer

  7. Department of Trauma, Orthopaedics and Plastic Surgery, University Hospital of Leipzig, Leipzig, Germany

    Niels Hammer

  8. Vienna, Austria

    Marco Johannes Maier

Authors
  1. Renate Krassnig
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gloria Maria Hohenberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Angelika Schwarz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Walter Prager
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peter Grechenig
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Niels Hammer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marco Johannes Maier
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by GH, AS and MM. The first draft of the manuscript was written by RK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Gloria Maria Hohenberger.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

All the investigated corpses were donated to the Division of Macroscopic and Clinical Anatomy of the Medical University of Graz under the approval of an ongoing body donation program and according to the Austrian curial law. While alive, the body donors consented to the postmortem donation of their tissues for research and teaching purposes.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Krassnig, R., Hohenberger, G.M., Schwarz, A. et al. Proportional localisation of the entry point of the coracobrachialis muscle by the musculocutaneous nerve along the humerus. Eur J Trauma Emerg Surg 49, 299–306 (2023). https://doi.org/10.1007/s00068-022-02063-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-022-02063-1

Keywords

Search

Navigation