The prevalence and distribution of the variants of pectoralis minor in cadaveric studies: A systematic review and meta-analysis of 32 observational studies

Introduction: Pectoralis minor (PMi) is used as a vascularized and innervated free-muscle graft in the reconstructive surgical procedure. The present review aims to provide insights to the surgeons regarding the variants of PMi in terms of costal attachment, insertion, nerve supply and arterial supp...

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Main Authors: Adil Asghar, Shagufta Naaz, Sunita Naya
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2021-01-01
Series:National Journal of Clinical Anatomy
Subjects:
Online Access:http://www.njca.info/article.asp?issn=2277-4025;year=2021;volume=10;issue=3;spage=164;epage=173;aulast=Asghar
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author Adil Asghar
Shagufta Naaz
Sunita Naya
author_facet Adil Asghar
Shagufta Naaz
Sunita Naya
author_sort Adil Asghar
collection DOAJ
description Introduction: Pectoralis minor (PMi) is used as a vascularized and innervated free-muscle graft in the reconstructive surgical procedure. The present review aims to provide insights to the surgeons regarding the variants of PMi in terms of costal attachment, insertion, nerve supply and arterial supply. Methodology: Three major databases (PubMed, EMBASE, and Google Scholar) were thoroughly searched along with the full text of journals. Results: Seven studies (n = 1787) were analysed for the evaluation of costal attachment. PMi arise from 3rd to 5th rib in 33% (95% confidence interval [CI], 30–37%), but the most common variants II-5 ribs was observed in 36%, which was higher than normal. Eighteen studies (n = 2424) reported details of insertion. The variant insertion of PMi was observed in 21% (15–28; 95% CI). Seven studies reported nerve supply. Both medial pectoral nerve (MPN) and lateral pectoral nerve (LPN) innervates PMi in 93% and MPN absent in 7%. Only two studies reported arterial supply. The PMi was vascularized by single dominant artery in 77% (68–85; 95% CI) or two arteries in 19% (13–29; 95% CI) or three arteries 2% (2–8; 95% CI) or even four arteries in 1% (0–7; 95% CI). Conclusion: PMi has a constant costal attachment to the 3rd and 4th ribs. Origin of PMi from 5th rib is reported with a pooled prevalence of 73.3% and from 2nd rib is reported in 61.5%. PMi inserts to the superomedial boundary of the coracoid process in 79% only.
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spelling doaj.art-014dfe74238e4e03959af2bbf18766542022-12-21T20:12:20ZengWolters Kluwer Medknow PublicationsNational Journal of Clinical Anatomy2277-40252321-27802021-01-0110316417310.4103/NJCA.NJCA_61_20The prevalence and distribution of the variants of pectoralis minor in cadaveric studies: A systematic review and meta-analysis of 32 observational studiesAdil AsgharShagufta NaazSunita NayaIntroduction: Pectoralis minor (PMi) is used as a vascularized and innervated free-muscle graft in the reconstructive surgical procedure. The present review aims to provide insights to the surgeons regarding the variants of PMi in terms of costal attachment, insertion, nerve supply and arterial supply. Methodology: Three major databases (PubMed, EMBASE, and Google Scholar) were thoroughly searched along with the full text of journals. Results: Seven studies (n = 1787) were analysed for the evaluation of costal attachment. PMi arise from 3rd to 5th rib in 33% (95% confidence interval [CI], 30–37%), but the most common variants II-5 ribs was observed in 36%, which was higher than normal. Eighteen studies (n = 2424) reported details of insertion. The variant insertion of PMi was observed in 21% (15–28; 95% CI). Seven studies reported nerve supply. Both medial pectoral nerve (MPN) and lateral pectoral nerve (LPN) innervates PMi in 93% and MPN absent in 7%. Only two studies reported arterial supply. The PMi was vascularized by single dominant artery in 77% (68–85; 95% CI) or two arteries in 19% (13–29; 95% CI) or three arteries 2% (2–8; 95% CI) or even four arteries in 1% (0–7; 95% CI). Conclusion: PMi has a constant costal attachment to the 3rd and 4th ribs. Origin of PMi from 5th rib is reported with a pooled prevalence of 73.3% and from 2nd rib is reported in 61.5%. PMi inserts to the superomedial boundary of the coracoid process in 79% only.http://www.njca.info/article.asp?issn=2277-4025;year=2021;volume=10;issue=3;spage=164;epage=173;aulast=Asgharaxillacoracoid processthoracic outlet syndrome
spellingShingle Adil Asghar
Shagufta Naaz
Sunita Naya
The prevalence and distribution of the variants of pectoralis minor in cadaveric studies: A systematic review and meta-analysis of 32 observational studies
National Journal of Clinical Anatomy
axilla
coracoid process
thoracic outlet syndrome
title The prevalence and distribution of the variants of pectoralis minor in cadaveric studies: A systematic review and meta-analysis of 32 observational studies
title_full The prevalence and distribution of the variants of pectoralis minor in cadaveric studies: A systematic review and meta-analysis of 32 observational studies
title_fullStr The prevalence and distribution of the variants of pectoralis minor in cadaveric studies: A systematic review and meta-analysis of 32 observational studies
title_full_unstemmed The prevalence and distribution of the variants of pectoralis minor in cadaveric studies: A systematic review and meta-analysis of 32 observational studies
title_short The prevalence and distribution of the variants of pectoralis minor in cadaveric studies: A systematic review and meta-analysis of 32 observational studies
title_sort prevalence and distribution of the variants of pectoralis minor in cadaveric studies a systematic review and meta analysis of 32 observational studies
topic axilla
coracoid process
thoracic outlet syndrome
url http://www.njca.info/article.asp?issn=2277-4025;year=2021;volume=10;issue=3;spage=164;epage=173;aulast=Asghar
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