Vol.:(0123456789) 1 3
Surgical and Radiologic Anatomy (2021) 43:619–630
https://doi.org/10.1007/s00276-020-02605-5
ORIGINAL ARTICLE
Anatomy of the axillary arch: from its incidence in human
to an embryologic and a phylogenetic explanation of its origins
Martin Lhuaire
1,2,3
· Karl Wehbe
4
· Ignacio Garrido
1
· Vincent Hunsinger
1
· Mohamed Derder
1
· Vincent Balaya
5
·
Vincent Delmas
2
· Peter Abrahams
6
· Daniele Sommacale
3
· Reza Kianmanesh
3
· Christian Fontaine
7
·
Laurent Lantieri
1
Received: 17 August 2020 / Accepted: 16 October 2020 / Published online: 2 November 2020
© Springer-Verlag France SAS, part of Springer Nature 2020
Abstract
Introduction Typically, the axillary arch is defned as a feshy slip running from latissimus dorsi to the anterior aspect of the
humerus. Phylogeny seems to give the most relevant and plausible explanation of this anatomical variant as a remnant of the
panniculus carnosus. However, authors are not unanimous about its origin. We report herein the incidence of axillary arch in
a series of 40 human female dissections and present an embryologic and a comparative study in three domestic mammals.
Materials and methods Forty formalin-preserved Caucasian human female cadavers, one rat (Rattus norvegicus), one rabbit
(Oryctolagus cuniculus) and one pig (Sus scrofa domesticus) cadavers were dissected bilaterally. A comparative, analytical
and a descriptive studies of serial human embryological sections were carried out.
Results We found an incidence of axillary arch of 2.5% (n = 1 subject of 40) in Humans. We found a panniculus carnosus
inserted on the anterior aspect of the humerus only in the rat and the rabbit but not in the pig. The development of the latis-
simus dorsi takes place between Carnegie stage 16–23, but the embryological study failed to explain the genesis of the
axillary arch variation. However, comparative anatomy argues in favour of a panniculus carnosus origin of the axillary arch.
Conclusions With an incidence of 2.5% of cases, the axillary arch is a relatively frequent variant that should be known by
clinician and especially surgeons. Moreover, while embryology seems to fail to explain the genesis of this variation, com-
parative study gives additional arguments which suggest a possible origin from the panniculus carnosus.
Keywords Comparative anatomy · Axillary arch · Rabbit · Pig · Rat
* Martin Lhuaire
martin.lhuaire@etu.parisdescartes.fr
1
Department of Plastic, Reconstructive and Aesthetic
Surgery, Hôpital Européen Georges Pompidou, Assistance
Publique des Hôpitaux de Paris, Université de Paris, 20 rue
Leblanc, 75908 Paris Cedex 15, France
2
Institute of Anatomy, URDIA, EA4465, UFR Biomédicale
des Saints-Pères, Université de Paris, Paris, France
3
Department of General and Digestive Surgery, Hôpital
Robert Debré, Centre Hospitalier Universitaire de Reims,
Université de Reims Champagne-Ardenne, Reims, France
4
Department of Gynecology and Oncology Surgery, Institut
Jean Godinot, Université de Reims Champagne-Ardenne,
Reims, France
5
Department of Gynecologic and Breast Oncologic Surgery,
Hôpital Européen Georges Pompidou, Assistance Publique
des Hôpitaux de Paris, Université de Paris, Paris, France
6
Institute of Anatomy and Clinical Education, Warwick
Medical School, University of Warwick, Coventry CV4 7AL,
UK
7
Faculté de Médecine Henri Warembourg, Institute
of Anatomy and Organogenesis, Université de Lille, Lille,
France