Dual innervation of the brachialis muscle

AbstractA study of the innervation of the brachialis muscle was carried out on 45 male and 31 female Thai cadavers between the ages of 15 and 92 years (mean = 59 years). The dissections revealed that all brachialis muscles received innervation from the musculocutaneous nerve and that 81.6% were also innervated by a branch from the radial nerve. Among the brachialis muscles with a dual nerve supply, two patterns of branching from the radial nerve were observed: in one pattern the branch to the brachialis had a descending course (58%) and in the other pattern the nerve ascended or recurred (42%) to innervate the muscle. The radial nerve branch penetrated the inferolateral part of the brachialis muscle in 83% of cases (103/124) and its middle third in 17% of specimens (21/124). The basis for the dual innervation may result from fusion of two different embryonic muscular primordia: the ventral (flexor) and the dorsal (extensor) muscle masses. In contrast to a brachialis muscle innervated by the musculocutaneous nerve only, a muscle with dual innervation may be spared significant denervation by an anterior approach to the humerus through a longitudinally bisected muscle. In a dually innervated muscle, however, separation of the brachialis and brachioradialis muscles during surgery may put the radial nerve branch to the brachialis at risk. Clin. Anat. 2:206–209, 2002. © 2002 Wiley‐Liss, Inc.