Research Article
Distal Insertional Footprint of the Brachialis Muscle:
3D Morphometric Study
Srinath Kamineni, Abdo Bachoura, William Behrens, Ellora Kamineni, and Andrew Deane
Elbow Shoulder Research Centre, University of Kentucky Department of Orthopaedic Surgery and Sports Medicine, Kentucky Clinic,
740 South Limestone, Lexington, KY 40536-0284, USA
Correspondence should be addressed to Srinath Kamineni; srinathkamineni@gmail.com
Received 24 May 2015; Revised 9 September 2015; Accepted 12 October 2015
Academic Editor: Levent Sarikcioglu
Copyright © 2015 Srinath Kamineni et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Objective. Te purpose of this study is to describe the three-dimensional morphometry of the brachialis muscle at its distal
attachment to the ulna. Methods. Fify cadaveric elbows were dissected and the brachialis distal insertion was isolated on the
ulna bone and probed with a three-dimensional digitizer, to create a three-dimensional model of the footprint. Measurements
and analysis of each footprint shape were recorded and compared based on gender and size. Results. Tere was signifcant gender
diference in the surface length (P = 0.002) and projected length (P = 0.001) of the brachialis footprint. Te shapes of the footprint
also difered among the specimens. Conclusion. Te shape of the brachialis muscle insertion difered among all the specimens
without signifcant variation in gender or sides. Tere was also a signifcant diference in muscle length between males and females
with little diference in the width and surface area. Signifcance. Te information obtained from this study is important for kinematic
understanding and surgical procedures around the elbow joint as well as the understanding of the natural age related anatomy of
the brachialis footprint morphology.
1. Introduction
Te brachialis muscle is the major elbow fexor. Te brachialis
tendon inserts distally to the coronoid process at the tuberos-
ity of the ulna. Tis distal attachment has been described by
previous studies as fbers of the brachialis muscle converging
to a thick, broad tendon which is attached to the tuberosity
of the ulna and to a rough impression on the anterior aspect
of the coronoid process [1–3]. It is innervated by branches of
the musculocutaneous and radial nerves [4, 5].
Injury to the brachialis is uncommon and reports are
ofen limited to small case series or case reports [6, 7]. As a
result, there has been little anatomical characterization of the
distal attachment of the brachialis muscle [1]. According to
Cage et al. [8], the brachialis muscle is injured during type III
coronoid fractures that involve disruption of more than 50%
of the height of the coronoid process, afecting the brachialis
distal tendinous insertion at the more proximal aspect of the
ulnar tuberosity.
Previous research on the muscle footprints took
measurements with calipers and MRI as illustrated in Table 1.
Tree-dimensional characterization allows for a more
objective morphometric analysis of the muscle footprint.
Tis study provides information on the qualitative and
quantitative morphometry of the distal brachialis muscle
insertion on the ulna. Te knowledge obtained from the
study contributes to our understanding of the functional and
anatomic characteristics of the brachialis muscle.
A better understanding of the muscle footprint could
be used to improve the current anterior and anterolateral
surgical approaches to repair fractures around the elbow
joint with ulnar bony involvement [1]. Although injury to
the brachialis muscle or tendon is rare, information from
this study could serve as a guide for orthopedic surgeons
considering the use of the brachialis tendon as a treatment
option in cases like brachialis tendon injuries, biceps brachii
tendon ruptures, brachial plexus injury, and coronoid process
fractures [2, 9].
2. Materials and Methods
Fify cadaveric upper limbs from twenty-eight formalin
preserved cadavers (University of Kentucky) were dissected
Hindawi Publishing Corporation
Anatomy Research International
Volume 2015, Article ID 786508, 6 pages
http://dx.doi.org/10.1155/2015/786508