Variations in the terminal branches of the brachial plexus in humans. A cadaveric study

Anatomical variation in the brachial plexus exists at different levels. Knowledge on the variations in terminal branches is of utmost importance especially to anesthesiologists and surgeons for peripheral nerve blocks' approaches and avoidance of perioperative complications during surgery respectively. We conducted this study to evaluate major variations in the local context.

The study was done to determine the anatomical variations in terminal branches of the brachial plexus among cadavers recruited from hospitals across Rwanda.

Forty-eight brachial plexus (24 human donors) were dissected and examined to assess the branching pattern and possible variations of terminal branches. All specimens were formalin-fixed and dissected. Nerves were identified macroscopically with nacked eyes. To be more specific in dissection, magnifiers were used for some nerves in order to visualize them with much of precision. The study was approved by Institutional Review Board of the University of Rwanda.

Forty-eight including 24 left and 24 right brachial plexuses (24 human donors) were dissected. All human bodies were adult aged between 28 and 72 years old. Considering gender disparity, 23/24 (96%) were male, only 1/24 (4%) was a female. From the 48 brachial plexus, 14 (29.2%) of them showed variations of its terminal branches where 9 cases (18.8%) are related to the variation of median nerve and 5 (10.4%) are related to other terminal branches. These deviations from the classical formation of the terminal branches may pose risks during surgical or anesthetic procedures if not known. They may also pose diagnostical challenges.

Anatomical variation of terminal branches of the brachial plexus are important and should be taken into consideration during clinical procedures for effective diagnosis and management of patients.