Unusual additional distal aponeurotic slips of biceps brachii: A rare variation

Abstract

Biceps brachii muscle is basically a powerful supinator. Although there is ample literature on variant origin of biceps brachii, variant insertion pattern was minimally reported. Here, we report a case, in which apart from usual insertion of biceps brachii, three distal accessory aponeurotic slips were found on the right arm of 55-year-old embalmed male cadaver. Two slips were arising from the lateral most part of bicipital aponeurosis traversing across the cubital fossa superficial to the brachial artery and median nerve and get attached to deep fascia covering the brachioradialis and pronator teres. Third accessory aponeurotic slip arises from the lateral side of biceps brachii muscle belly, traversing superficial to the musculocutaneous nerve and get attached to deep fascia covering the lateral border of brachioradialis and extensor carpi radialis longus. These extra slips may affect the kinematics of biceps brachii muscle and adds to the differential diagnosis of variety of clinical symptoms of neurovascular syndrome.