Variation in the Brachial Plexus in Midwestern American Donor Bodies

Abstract

Background/Objectives: The brachial plexus is a complex network of nerves responsible for the sensory and motor functions of the upper limbs. While extensively studied, the typical configuration taught only sometimes matches what is found in individuals, as numerous variations have been documented. These variations can have significant clinical and surgical implications. This study explored the prevalence and types of brachial plexus variations in donor bodies from the Midwestern United States. Methods: Using bodies donated through the Gift of Body Donation program at A.T. Still University’s Kirksville College of Osteopathic Medicine, the brachial plexuses of 32 donors were analyzed. Results: Among the 64 plexuses examined, 33 (52%) had a typical M-shaped median nerve formation without additional variations, 18 (28%) had a typical M-shaped formation with additional variations, 6 (9%) had an abnormal M without other variations, and 7 (11%) had an abnormal M with other variations. Thus, 31 plexuses (48%) showed atypical branching patterns. The most common variations were extra communicating branches, observed in 17 (55%) of the 31 variant plexuses. These branches were most often found between the medial and lateral cords (13/17, 76%) and between the musculocutaneous and median nerves (4/17, 24%). Other, less common variations included variant nerves, small branches, and rejoining nerves. Conclusions: This study highlights the significant prevalence of variations in the brachial plexus, which may impact clinical and surgical practices. Further research is needed to fully understand the implications of these variations, especially in procedures like nerve blocks and reconstructive surgeries.