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

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

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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 Mug 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 Machines in 61.5%.

PMi inserts to the superomedial boundary of the coracoid process in 79% only.