Surgical Exposure of the Brachial Plexus

ABSTRACT

The brachial plexus is a complex anatomic entity, which encompasses an extensive territory from the cervicothoracic spine to the axilla and proximal arm. Surgical exposures of the brachial plexus have been devised to optimize access to the various elements of the plexus. No single approach provides safe, extensile exposure of all of the plexus structures simultaneously. Therefore, the brachial plexus surgeon must be familiar with several approaches in order to deal effectively with the variety of pathology that affects the plexus elements. Familiarity with these approaches allows the surgeon to select the optimal approach for the patient's specific pathology. This article reviews the anterior supraclavicular, anterior infraclavicular, and posterior subscapular approaches to the brachial plexus. The importance of understanding the complex, three-dimensional surgical anatomy is emphasized. The applications of each approach as well as the keys to avoidance of complications are presented.

KEYWORD

Brachial plexus - supraclavicular - infraclavicular - posterior subscapular

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