open access

Vol 82, No 2 (2023)
Original article
Submitted: 2021-10-02
Accepted: 2022-01-17
Published online: 2022-02-28
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Anatomical variations of the biceps brachii insertion: a proposal for a new classification

B. Szewczyk1, F. Paulsen23, R. F. LaPrade4, A. Borowski5, N. Zielinska1, Ł. Olewnik1
·
Pubmed: 35239179
·
Folia Morphol 2023;82(2):359-367.
Affiliations
  1. Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland
  2. Institute of Functional and Clinical Anatomy, Erlangen, Germany
  3. Department of Topographic Anatomy and Operative Surgery, Sechenov University, Moscow, Russia
  4. Twin Cities Orthopaedics, Edina, Minnesota, United States
  5. Clinic of Orthopaedic and Paediatric Orthopaedics, Medical University of Lodz, Poland

open access

Vol 82, No 2 (2023)
ORIGINAL ARTICLES
Submitted: 2021-10-02
Accepted: 2022-01-17
Published online: 2022-02-28

Abstract

Background: The biceps brachii (BB) muscle is one of the three muscles located
in the anterior compartment of the arm. Its insertion consists of two parts. The
first part — main tendon — attached in the radial tuberosity and the second part
— lacertus fibrosus (LF) — in the fascia of the forearm flexors. The intention of
research was to reveal the morphological diversity of the insertion of this muscle.
Thanks to the results of this work, have been created a classification of the distal
attachment of BB. The results of that research can be used to further develop
surgical procedures in the given region.
Materials and methods: Eighty (40 left, and 40 right, 42 female, 38 male) upper
limbs fixed in 10% formalin solution were examined.
Results: We observed three types of the insertion of the BB. Type I was characterised
by a single tendon and occurred most frequently in 78.75% of the examined
limbs. The second most common type was type II which was characterised by
a double tendon and was observed in 13.75% of all the limbs. The last and least
common was type III which was characterised by three tendons and occurred
in 7.5% of the examined limbs. Additionally, the type of LF was analysed. In
8 (10%) specimens it was absent, i.e. in 2 specimens with type II insertion and
6 specimens with type III (p = 0.0001). Therefore, it may be deduced that type
III BB insertion tendon predisposes to LF deficiency.
Conclusions: The BB tendon is characterised by high morphological variability.
The new classification proposes three types of distal attachment: type I — one
tendon; type II — two separated band-shaped tendons; type III — three separated
band-shaped tendons. The presence of type III BB tendon predisposes to a lack
of LF.

Abstract

Background: The biceps brachii (BB) muscle is one of the three muscles located
in the anterior compartment of the arm. Its insertion consists of two parts. The
first part — main tendon — attached in the radial tuberosity and the second part
— lacertus fibrosus (LF) — in the fascia of the forearm flexors. The intention of
research was to reveal the morphological diversity of the insertion of this muscle.
Thanks to the results of this work, have been created a classification of the distal
attachment of BB. The results of that research can be used to further develop
surgical procedures in the given region.
Materials and methods: Eighty (40 left, and 40 right, 42 female, 38 male) upper
limbs fixed in 10% formalin solution were examined.
Results: We observed three types of the insertion of the BB. Type I was characterised
by a single tendon and occurred most frequently in 78.75% of the examined
limbs. The second most common type was type II which was characterised by
a double tendon and was observed in 13.75% of all the limbs. The last and least
common was type III which was characterised by three tendons and occurred
in 7.5% of the examined limbs. Additionally, the type of LF was analysed. In
8 (10%) specimens it was absent, i.e. in 2 specimens with type II insertion and
6 specimens with type III (p = 0.0001). Therefore, it may be deduced that type
III BB insertion tendon predisposes to LF deficiency.
Conclusions: The BB tendon is characterised by high morphological variability.
The new classification proposes three types of distal attachment: type I — one
tendon; type II — two separated band-shaped tendons; type III — three separated
band-shaped tendons. The presence of type III BB tendon predisposes to a lack
of LF.

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Keywords

biceps brachii, biceps brachii tendon, lacertus fibrosus, bicipital aponeurosis, new classification

About this article
Title

Anatomical variations of the biceps brachii insertion: a proposal for a new classification

Journal

Folia Morphologica

Issue

Vol 82, No 2 (2023)

Article type

Original article

Pages

359-367

Published online

2022-02-28

Page views

2611

Article views/downloads

1687

DOI

10.5603/FM.a2022.0022

Pubmed

35239179

Bibliographic record

Folia Morphol 2023;82(2):359-367.

Keywords

biceps brachii
biceps brachii tendon
lacertus fibrosus
bicipital aponeurosis
new classification

Authors

B. Szewczyk
F. Paulsen
R. F. LaPrade
A. Borowski
N. Zielinska
Ł. Olewnik

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