Median nerve and brachial artery entrapment in the abnormal brachialis muscle – a case report

Knowledge of variation in the pattern of muscle insertion and possible neurovascular entrapment is importantfor orthopedic surgeons, plastic surgeons and physiotherapists. We found a variation in the insertion pattern of brachialis and entrapped median nerve and brachial artery dueto the superficial position of the muscle, in relation to the neurovascular bundle. The brachialis was found tohave an additional thick slip from the distal third of the muscle. The accessory slip partly merged with the originof superficial flexors of the forearm and partly inserted to the medial aspect of olecranon process. The mediannerve and brachial artery passed under this additional slip of brachialis. The abnormality reported here might result in neurovascular compression symptoms in upper limb and somemechanical advantages or disadvantage in the flexion of elbow joint.