Infraclavicular Topography of the Brachial Plexus Fascicles in Different Upper Limb Positions

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Daniel Alves dos Santos; Amilton Iatecola; Cesar Adriano Dias Vecina; Eduardo Jose Caldeira; Ricardo Noboro Isayama; Erivelto Luis Chacon; Marianna Carla Alves; Evanisi Teresa Palomari; Maria Jose Salete Viotto & Marcelo Rodrigues da Cunha


Brachial plexus neuropathies are common complaints among patients seen at orthopedic clinics. The causes range from traumatic to occupational factors and symptoms include paresthesia, paresis, and functional disability of the upper limb. Treatment can be surgical or conservative, but detailed knowledge of the brachial plexus is required in both cases to avoid iatrogenic injuries and to facilitate anesthetic block, preventing possible vascular punctures. Therefore, the objective of this study was to evaluate the topography of the infraclavicular brachial plexus fascicles in different upper limb positions adopted during some clinical procedures. A formalin- preserved, adult, male cadaver was used. The infraclavicular and axillary regions were dissected and the distance of the brachial plexus fascicles from adjacent bone structures was measured. No anatomical variation in the formation of the brachial plexus was observed. The metric relationships between the brachial plexus and adjacent bone prominences differed depending on the degree of shoulder abduction. Detailed knowledge of the infraclavicular topography of neurovascular structures helps with the diagnosis and especially with the choice of conservative or surgical treatment of brachial plexus neuropathies.

KEY WORDS: Brachial plexus; Topography; Peripheral nerve injuries; Upper limb.

How to cite this article

ALVES DOS SANTOS, D.; IATECOLA, A.; DIAS VECINA, C. A.; CALDEIRA, E. J.; NOBORO ISAYAMA, R.; CHACON, E. L.; ALVES, M. C.; PALOMARI, E. T.; SALETE VIOTTO, M. J. & RODRIGUES DA CUNHA, M. Infraclavicular topography of the brachial plexus fascicles in different upper limb positions. Int. J. Morphol., 34 (3):1063-1068, 2016.