Cadaveric morphometric analysis of neurovascular variations in the brachial plexus and their clinical implications: A cross-sectional cadaveric study.

Mrinalini  Sinha; Birendra Kumar  Sinha; Amrita  Kumari; Nafees  Fatima

doi:10.51168/sjhrafrica.v7i2.2623

Authors

Mrinalini Sinha MBBS, MS, tutor, Department of Anatomy, Patna Medical College & Hospital, Patna, Bihar, India
Birendra Kumar Sinha Professor and HOD, Department of Anatomy, Patna Medical College & Hospital, Patna, Bihar, India
Amrita Kumari Associate Professor, Department of Anatomy, Patna Medical College & Hospital, Patna, Bihar, India
Nafees Fatima Associate Professor, Department of Anatomy, Patna Medical College & Hospital, Patna, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v7i2.2623

Keywords:

Brachial plexus, Anatomical variation, Cadaveric study, Neurovascular relationships, Regional anesthesia, Morphometry

Abstract

Background
The brachial plexus exhibits considerable anatomical variation, particularly in its neurovascular relationships. These variations are clinically important because they may influence surgical procedures, regional anesthesia, and the management of traumatic injuries involving the upper limb.
Objectives: To analyze the morphometric characteristics and neurovascular variations of the brachial plexus in cadaveric specimens and evaluate their clinical implications.

Methods
This cross-sectional cadaveric observational study was conducted over 12 months and included 100 adult cadaveric specimens. The specimens comprised 70 males and 30 females, with a mean age of 58.6 ± 11.4 years at death. Standard anatomical dissection was performed to identify variations in the roots, trunks, cords, and terminal branches of the brachial plexus and their relationships with adjacent vascular structures. Morphometric measurements were recorded using standardized techniques and analyzed statistically, with p < 0.05 considered statistically significant.

Results
Anatomical variations were identified in 35% of the specimens. Variations were most frequently observed at the cord level (25%), followed by the trunks (20%) and roots (15%). Neurovascular relationship variations were present in 35% of the specimens and were significantly associated with increased potential surgical and anesthetic challenges (p < 0.05). Morphometric analysis demonstrated significant variability in the branching patterns and neurovascular relationships of the brachial plexus, highlighting the complexity of upper limb anatomy.

Conclusion
Anatomical variations of the brachial plexus are common and have important clinical implications for surgical and anesthetic procedures. Recognition of these variations can reduce the risk of iatrogenic nerve and vascular injuries.

Recommendation
Surgeons, anesthesiologists, and radiologists should routinely consider possible brachial plexus variations during preoperative planning and regional anesthesia. Further multicenter cadaveric studies with larger sample sizes are recommended to validate these findings.

Author Biographies

Mrinalini Sinha, MBBS, MS, tutor, Department of Anatomy, Patna Medical College & Hospital, Patna, Bihar, India

MBBS, MS, is a Tutor in the Department of Anatomy, Patna Medical College & Hospital, Patna, Bihar, India. Her academic interests include gross anatomy, neuroanatomy, cadaveric research, anatomical variations, and clinically applied anatomy.

Birendra Kumar Sinha, Professor and HOD, Department of Anatomy, Patna Medical College & Hospital, Patna, Bihar, India

MBBS, MD, is Professor and Head of the Department of Anatomy, Patna Medical College & Hospital, Patna, Bihar, India. His areas of expertise include gross anatomy, embryology, neuroanatomy, anatomical research, and medical education. He has extensive experience in teaching, academic leadership, and anatomical research.

Amrita Kumari, Associate Professor, Department of Anatomy, Patna Medical College & Hospital, Patna, Bihar, India

MBBS, MD, is an Associate Professor in the Department of Anatomy, Patna Medical College & Hospital, Patna, Bihar, India. Her research interests include gross anatomy, embryology, cadaveric studies, anatomical variations, and medical education.

Nafees Fatima, Associate Professor, Department of Anatomy, Patna Medical College & Hospital, Patna, Bihar, India

MBBS, MD, is an Associate Professor in the Department of Anatomy, Patna Medical College & Hospital, Patna, Bihar, India. Her academic and research interests include neuroanatomy, clinically applied anatomy, cadaveric research, anatomical variations, and undergraduate and postgraduate medical education.

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