The course and variations of the branches of the musculocutaneous nerve in human fetuses

Abstract

The course and branches of the musculocutaneous nerve (MCN) were dissected in 140 human fetal arms. The MCN entered the superior, middle, and inferior part of coracobrachialis in 43%, 37%, and 17% of arms, respectively, and the remaining 3% did not pierce coracobrachialis. The motor branches to biceps were classified as follows: Type 1 (83.6%): a single branch that bifurcated to supply the two heads of biceps; Type 2 (14.3%): two separate branches each innervating one head of biceps; Type 3 (2.1%): a single branch that bifurcated to supply each head of biceps plus an additional branch that innervated the distal part of biceps. The motor branches to brachialis were classified as follows: Type 1 (93.6%): a single branch to brachialis; Type 2 (6.4%): a single branch that bifurcated into two branches both supplying brachialis. Communications between the MCN and the median nerve (MN) were observed in 10% of specimens, of which three types (A, B, C) could be identified depending on their origin and union. In the most frequently observed type (B, 50% of cases) the communicating branch arose from the proximal part of the MCN and joined the MN in the middle or distal part of arm. The data presented here will be of use to surgeons, especially pediatric surgeons who undertake surgical procedures in the axilla and arm.