The Role of the Axillary Arch Variant in Neurovascular Syndrome of Brachial Plexus Compression

Axillary arch muscles are often found. In their course through this area, they might interfere with regional neurovascular structures. This case report will examine the presence of the axillary arch muscle and its implication in brachial plexus compression. During routine dissection of the left axilla and upper limb, a variant muscle (axillary arch muscle) was identified arising from the distal tendon of the latissimus dorsi and extending laterally to insert onto the deep surface of the tendon of insertion of the deltoid muscle. In adduction of the upper limb, the muscle was lax without compression of any underlying neurovascular structures. However, in abduction, the aberrant band of muscles compressed the proximal branches of the brachial plexus. Clinicians should be aware of this anatomical variant and its clinical significance in neurovascular compression including brachial plexus compression, thoracic outlet syndrome, and hyperabduction syndrome. This literature will review the anatomy of the axillary arch and its clinical correlate regarding signs, symptoms, diagnosis, and treatment in brachial plexus compression.

[1]  J. Gowdy,et al.  MRI of the axillary arch muscle: prevalence, anatomic relations, and potential consequences. , 2011, AJR. American journal of roentgenology.

[2]  R. Tubbs,et al.  Variation of the axillary arch muscle with multiple insertions. , 2009, Singapore medical journal.

[3]  K. Harbaugh,et al.  THE MUSCULAR AXILLARY ARCH: AN ANATOMIC STUDY AND CLINICAL CONSIDERATIONS , 2008, Neurosurgery.

[4]  G. Vanderstraeten,et al.  The impact of muscular variation on the neurodynamic test for the median nerve in a healthy population with Langer's axillary arch. , 2008, Journal of manipulative and physiological therapeutics.

[5]  Walid Zaher,et al.  Axillary arch: a rare variation , 2008 .

[6]  G. Georgiev,et al.  Axillary arch in human: common morphology and variety. Definition of "clinical" axillary arch and its classification. , 2007, Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft.

[7]  G. Georgiev,et al.  Axillary arch in Bulgarian population: Clinical significance of the arches , 2007, Clinical anatomy.

[8]  J. P. Cummings,et al.  The axillary arch: anatomy and suggested clinical manifestations. , 2006, The Journal of orthopaedic and sports physical therapy.

[9]  M. Greenall,et al.  Langer's axillary arch: anatomy, embryological features and surgical implications. , 2005, The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland.

[10]  N. Gülekon,et al.  Axillopectoral muscle (Langer's muscle) , 2005, Clinical anatomy.

[11]  I. Daniels,et al.  The axillary arch of Langer – The most common muscular variation in the axilla , 2004, Breast Cancer Research and Treatment.

[12]  J. Mérida-Velasco,et al.  Axillary arch: Potential cause of neurovascular compression syndrome , 2003, Clinical anatomy.

[13]  J. Clarys,et al.  The muscular arch of the axilla revisited: its possible role in the thoracic outlet and shoulder instability syndromes. , 1996, Manual therapy.

[14]  S. Sürücü,et al.  An axillary arch , 1996, Clinical anatomy.