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Anatomy and surgical landmarks for the ansa pectoralis: application to pectoralis major nerve selective neurotomy

  • Anatomic Bases of Medical, Radiological and Surgical Techniques
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Abstract

Background

Ansa pectoralis neurotomy is a surgical approach in the treatment of the pectoralis major muscle spasticity causing an attitude in adduction and internal rotation of the shoulder.

Objective

To establish the anatomical landmarks allowing an easier localisation of the ansa pectoralis during neurotomy.

Material and methods

Fifteen adult human cadavers (10 embalmed and 5 fresh) were dissected in order to determine anatomical landmarks allowing an easier localization of the ansa pectoralis during neurotomy.

Results

In all the cadavers, the lateral pectoral nerve arose from the lateral cord of the brachial plexus, 0.2 cm above to 1.5 cm below the inferior border of the clavicle with a mean distance of 0.76 cm for left and right side, whereas the medial pectoral nerve arose from the medial cord of the brachial plexus, 0.7–2.3 cm below the inferior border of the clavicle with a mean distance of 0.61 cm for the left side and 0.68 cm for the right side. We systematically found both the origin of pectoral nerves and the ansa pectoralis at the level of the middle third of the distance between the sternoclavicular and the acromioclavicular joints. Moreover, ansa pectoralis was constantly localized lateral to the thoracoacromial artery. In four cases, the division of the lateral pectoral nerve was not found. In one case, medial pectoral nerve did not exist.

Conclusion

Ansa pectoralis can be found by a curved incision made at the mid-third of the distance between the sternoclavicular and the acromioclavicular joints, the medial point being located just below the lower edge of the clavicle and the lateral point 2 cm below the inferior edge of the clavicle.

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Authors and Affiliations

  1. Laboratoire d’Anatomie et d’Organogenèse, Université de Picardie Jules Verne, Amiens, France

    Maud Creze, Johann Peltier, Eric Havet, Pascal Foulon & Daniel Le Gars

  2. Service de Neuroradiologie, Place Victor Pauchet, 80054, Amiens Cedex 1, France

    Maud Creze & Arnaud Potier

  3. Service de Neurochirurgie, CHU Amiens Nord, Place Victor Pauchet, 80054, Amiens Cedex 1, France

    Johann Peltier, Eric Havet, Michel Lefranc & Daniel Le Gars

  4. Service de Radiologie, Centre Hospitalier Universitaire d’Amiens, Place Victor Pauchet, 80054, Amiens Cedex 1, France

    Maud Creze & Arnaud Potier

Authors
  1. Maud Creze
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  2. Johann Peltier
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  3. Eric Havet
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  4. Arnaud Potier
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  5. Michel Lefranc
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  6. Pascal Foulon
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  7. Daniel Le Gars
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Correspondence to Maud Creze.

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Creze, M., Peltier, J., Havet, E. et al. Anatomy and surgical landmarks for the ansa pectoralis: application to pectoralis major nerve selective neurotomy. Surg Radiol Anat 34, 943–951 (2012). https://doi.org/10.1007/s00276-012-0990-3

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  • DOI: https://doi.org/10.1007/s00276-012-0990-3

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