A Case Report of a Rare Variation in the Lateral Cord of the Brachial Plexus

The brachial plexus is the largest and most complex neural plexus in the body located in the neck and axilla. So far, there have been many reports of various variations in the brachial plexus that are of clinical significance. In the present study, while dissecting the upper limb of a 54-year-old man in the dissection room of Shahid Sadoughi University of Medical Sciences in Yazd, a rare variation was observed in the lateral cord branches of the plexus. In this case, the medial pectoral nerve, which normally separates from the medial cord, originated from the lateral cord. Awareness of this variation is important for anatomists, surgeons, anesthesiologists and radiologists to interpret the graphs, etc., and can help to reduce clinical complications during surgery and better interpret and diagnose the graphs.

Electrodiagnosis of Medial Pectoral Nerve Mononeuropathy

With an increased awareness to maintain physical fitness, weight training has become increasingly popular. Neurologic injuries are one of many injuries which can occur accidentally or with improper technique. We present a case of an isolated right medial pectoral nerve mononeuropathy in a 48-year-old male weightlifter.

Intercostal and pectoral nerve transfers to re-innervate the biceps muscle in obstetric brachial plexus lesions

In obstetric brachial plexus lesions with avulsion injury, nerve grafting for biceps muscle re-innervation may not be possible owing to the unavailability of a proximal stump. In such cases, the intercostal nerves or medial pectoral nerve can serve as donor nerves in an end-to-end transfer to the musculocutaneous nerve. The present study reports the results of both techniques from a single institution in a consecutive series of 42 patients between 1995 and 2008. From 1995 to 2000 we always used the intercostal nerve transfer, and from 2001 to 2008 both techniques were used. Biceps muscle force ≥Medical Research Council Grade 3 was achieved in 37 of 42 patients after a mean follow-up of 44 months. There was no statistical difference in the results in the medial pectoral nerve transfer group ( n = 25) and the intercostal nerve transfer group ( n = 17).

Reanimation of elbow extension with medial pectoral nerve transfer in partial injuries to the brachial plexus

Object Recent advancements in operative treatment of the brachial plexus authorized more extensive repairs and, currently, elbow extension can be included in the rank of desirable functions to be restored. This study aims to describe the author's experience in using the medial pectoral nerve for reinnervation of the triceps brachii in patients sustaining C5–7 palsies of the brachial plexus. Methods This is a retrospective study of the outcomes regarding recovery of elbow extension in 12 patients who underwent transfer of the medial pectoral nerve to the radial nerve or to the branch of the long head of the triceps. Results The radial nerve was targeted in 3 patients, and the branch to the long head of the triceps was targeted in 9. Grafts were used in 6 patients. Outcomes assessed as Medical Research Council Grades M4 and M3 for elbow extension were noted in 7 (58%) and 5 (42%) patients, respectively. Conclusions The medial pectoral nerve is a reliable donor for elbow extension recovery in patients who have sustained C5–7 nerve root injuries.

Collateral branches of the brachial plexus as donors in nerve transfers

Background/Aim. Nerve transfers in cases of directly irreparable, or high level extensive brachial plexus traction injuries are performed using a variety of donor nerves with various success but an ideal method has not been established. The purpose of this study was to analyze the results of nerve transfers in patients with traction injuries to the brachial plexus using the thoracodorsal and medial pectoral nerves as donors. Methods. This study included 40 patients with 25 procedures using the thoracodorsal nerve and 33 procedures using the medial pectoral nerve as donors for reinnervation of the musculocutaneous or axillary nerve. The results were analyzed according to the donor nerve, the age of the patient and the timing of surgery. Results. The total rate of recovery for elbow flexion was 94.1%, for shoulder abduction 89.3%, and for shoulder external rotation 64.3%. The corresponding rates of recovery using the thoracodorsal nerve were 100%, 93.7% and 68.7%, respectively. The rates of recovery with medial pectoral nerve transfers were 90.5%, 83.3% and 58.3%, respectively. Despite the obvious differences in the rates of recovery, statistical significance was found only between the rates and quality of recovery for the musculocutaneous and axillary nerve using the thoracodorsal nerve as donor. Conclusion. According to our findings, nerve transfers using collateral branches of the brachial plexus in cases with upper palsy offer several advantages and yield high rate and good quality of recovery.