Abstract
IntroductionThe innervation pattern of the clavicular head of the deltoid muscle and its corresponding topography was investigated via cadaveric dissection in the present study, focusing on the lateral pectoral nerve.Materials and methodsFifty‐eight upper extremities were dissected and the nerve supplies to the deltoid muscle and the variability of the lateral pectoral and axillary nerves, including their topographical patterns, were noted.ResultsThe clavicular portion of the deltoid muscle received a deltoid branch from the lateral pectoral nerve in 86.2% of cases. Two topographical patterns of the lateral pectoral nerve were observed, depending on the branching level from the brachial plexus: a proximal variant, where the nerve entered the pectoral region under the clavicle, and a distal variant, where the nerve entered the pectoral region from the axillary fossa around the caudal border of the pectoralis minor. These dissection findings were supported by histological confirmation of peripheral nerve tissue entering the clavicular part of the deltoid muscle.ConclusionsThe topographical variations of the lateral pectoral nerve are relevant for orthopedic and trauma surgeons and neurologists. These new data could revise the interpretation of deltoid muscle atrophy and of thoracic outlet and pectoralis minor compression syndromes. They could also explain the residual anteversion function of the arm after axillary nerve injury and deficiency, which is often thought to be related to biceps brachii muscle function.
Highlights
The innervation pattern of the clavicular head of the deltoid muscle and its corresponding topography was investigated via cadaveric dissection in the present study, focusing on the lateral pectoral nerve
Anatomical dissection of 58 upper limbs (29 rights and 29 lefts) from 29 cadavers was used to investigate the relationships of the lateral pectoral nerve to the deltoid muscle and identify the probable topographic variants of the innervation
Innervation pattern through the axillary nerve and its distribution in the deltoid muscle have been well defined by Stecco, Sakoma, Wysiadecki, Leechavengvongs and their colleagues (Leechavengvongs et al, 2015; Sakoma et al, 2011; Stecco et al, 2010; Wysiadecki et al, 2014)
Summary
The innervation pattern of the clavicular head of the deltoid muscle and its corresponding topography was investigated via cadaveric dissection in the present study, focusing on the lateral pectoral nerve. Two topographical patterns of the lateral pectoral nerve were observed, depending on the branching level from the brachial plexus: a proximal variant, where the nerve entered the pectoral region under the clavicle, and a distal variant, where the nerve entered the pectoral region from the axillary fossa around the caudal border of the pectoralis minor These dissection findings were supported by histological confirmation of peripheral nerve tissue entering the clavicular part of the deltoid muscle. Conclusions: The topographical variations of the lateral pectoral nerve are relevant for orthopedic and trauma surgeons and neurologists These new data could revise the interpretation of deltoid muscle atrophy and of thoracic outlet and pectoralis minor compression syndromes. The anterior head contains two segments (S1–S2), Clinical Anatomy. 2020;1–7
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