Variations and Lesions at the Level of the Terminal Branches of the Brachial Plexus

The lesions of the brachial plexus terminal nerves can occur in various levels, quite frequently caused by humeral fractures. Observed variations of the brachial plexus terminal branches are presented in the tables. Axillary nerve lesions are associated with abduction to the side and lifting arm forward and backward problems. The radial nerve lesions show flexion and extension of elbow paresis, impaired forearm supination, wrist and finger extension, and thumb abduction. Its usual branch - the posterior interosseus antebrachial nerve also shows quite a variable branching patern. The musculocutaneous nerve lesions can result in the atrophy of innervated muscle and weakness of the shoulder flexion and supination. In eight cases, we found it missing. The median nerve is a mixed nerve, so its lesions show motor, sensory, and trophic disorders according to the level of the lesion. The various variations of the mutual branching patterns of the musculocutaneous and median nerves were observed and documented. The ulnar nerve lesions (according to the level of damage) affect the range of motion, muscle strength weakening, atrophy, and sensitivity disorders in supplying areas. Brachial plexopathies are usually the result of trauma, genetic mutations, primary autoimmune processes, radiotherapy, or neoplastic infiltration. They are presented by limb muscle asymmetric weakness and sensory deficits that do not correspond to the individual roots and nerve distribution. The autonomic sympathetic fibres disorders (accompanying brachial plexus inferior trunk lesions) can include skin trophic changes, regional pain complex syndrome, and Horner’s syndrome.