Figure 5

Exploration of the brachial plexus through a supraclavicular approach on the left side of the 17 year old girl. After skin incision and incision of the fascia the brachial plexus (arrow; A) was located very superficially riding on the cervical rib (arrow; B) and with a distorted anatomy of the brachial plexus rather twisted and horizontally located on top of the cervical rib. The cervical rib was resected in pieces (large arrow cervical rib; small arrow fibrous tissue; C) and the surface of the remaining exposed bone was covered with bone wax. After resection of a cervical rib, the brachial plexus was no longer distorted by any structures and the subclavian artery could be observed (arrow in D). Photos taken from below with the left arm to the right and the head to the left.