A Cadaveric Study on Variations of the Brachial Plexus and Their Surgical Implications

Abstract

Background: The brachial plexus is a complex network of nerves supplying the upper limb and is known to exhibit numerous anatomical variations. These variations may involve the roots, trunks, cords, and terminal branches and are of considerable clinical importance for surgeons, anesthesiologists, orthopaedic surgeons, and radiologists. Knowledge of such variations is essential to prevent iatrogenic nerve injuries during surgical procedures, regional nerve blocks, and trauma management.

Methods: This descriptive cadaveric observational study was conducted in the Department of Anatomy at N K P Salve Institute of Medical Sciences, Nagpur. A total of 30 embalmed adult cadavers comprising 60 upper limbs were dissected bilaterally. Detailed examination of the brachial plexus was performed to identify variations in roots, trunks, divisions, cords, terminal branches, and their relation to surrounding vascular structures. Findings were recorded, tabulated, and analyzed using descriptive statistics.

Results: Variations in the brachial plexus were observed in 22 out of 60 upper limbs (36.7%). The most common variation was communication between the musculocutaneous and median nerves, seen in 8 limbs (13.3%). Prefixed plexus was observed in 4 limbs (6.7%), while postfixed plexus was seen in 2 limbs (3.3%). Variations in trunk formation, cord branching, and relation to the axillary artery were also noted.

Conclusion: The brachial plexus demonstrates significant anatomical variability. Awareness of these variations is important for safe surgical dissection, effective regional anesthesia, and accurate radiological interpretation.