Anatomical Study of Variations in the Branching Patterns of Neurovascular Pedicle of Latissimus Dorsi

Abstract

Introduction Variations in the branching and position of the dominant pedicle of the Latissimus Dorsi (LD) muscle has been noted during dissection of the posterior aspect of the cadaver. Knowledge about the point of branching of the pedicle is highly valuable for the surgeon while performing various reconstructive surgeries. Aims and Objectives To analyze and study the insertion and branching of the dominant neurovascular pedicle of LD. Material and Methods A total 40 LD muscles were excised from the point of origin and retracted superior-laterally towards its insertion. The pedicle was then cleared of any unwanted fascia by strip dissection and the point of branching was identified with respect to the level of the inferior scapular angle (ISA). Results An anatomical variation was observed in the study of the branching of the neurovascular pedicle. Upon consideration via statistical calculations, the following levels of branching locations were noted. ~12.5% - 2.0-inch superior to level of ISA ~37.5% - 1.0-inch superior to level of ISA ~25.0% - 1.5-inch superior to level of ISA ~25.0% - 0.4-inch inferior to level of ISA The first three types were considered as early branching whereas the last type was considered as late branching of LD. Conclusion This study shows the variations in the branching in the pedicle of the LD at various points that were considered. This is hence of surgical importance that must be noted to prevent surgical vascular damage that may occur during procedures and increase the methodology of pre-operative planning