Anatomic localization of motor entry point of superficial peroneal nerve to peroneus longus and brevis muscles

Lee, Je‐Hun; Lee, Be-Na; An, Xiaochun; Chung, Rak-Hee; Kwon, Seong-Oh; Han, Seung‐Ho

doi:10.1002/ca.21076

Cited by 29 publications

(17 citation statements)

References 21 publications

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“…The superficial peroneal nerve innervates the peroneus longus and brevis muscles, while the deep peroneal nerve innervates the anterior leg muscles. In agreement with our findings, Lee et al (2011) recently demonstrated that the motor entry points of the superficial peroneal nerve supplying the peroneus longus muscle were located from 10 to 60% of the distance between the apex of the fibular head and the apex of the lateral malleolus. To our knowledge, no previous study attempted to localize the motor points of the deep peroneal nerve to the tibialis anterior muscle.…”

Section: Motor Point Location and Uniformitysupporting

confidence: 94%

Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning

et al. 2011

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The aim of the study was to investigate the uniformity of the muscle motor point location for lower limb muscles in healthy subjects. Fifty-three subjects of both genders (age range: 18-50 years) were recruited. The muscle motor points were identified for the following ten muscles of the lower limb (dominant side): vastus medialis, rectus femoris, and vastus lateralis of the quadriceps femoris, biceps femoris, semitendinosus, and semimembranosus of the hamstring muscles, tibialis anterior, peroneus longus, lateral and medial gastrocnemius. The muscle motor point was identified by scanning the skin surface with a stimulation pen electrode and corresponded to the location of the skin area above the muscle in which an electrical pulse evoked a muscle twitch with the least injected current. For each investigated muscle, 0.15 ms square pulses were delivered through the pen electrode at low current amplitude (<10 mA) and frequency (2 Hz). 16 motor points were identified in the 10 investigated muscles of almost all subjects: 3 motor points for the vastus lateralis, 2 motor points for rectus femoris, vastus medialis, biceps femoris, and tibialis anterior, 1 motor point for the remaining muscles. An important inter-individual variability was observed for the position of the following 4 out of 16 motor points: vastus lateralis (proximal), biceps femoris (short head), semimembranosus, and medial gastrocnemius. Possible implications for electrical stimulation procedures and electrode positioning different from those commonly applied for thigh and leg muscles are discussed.

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Section: Motor Point Location and Uniformitysupporting

confidence: 94%

Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning

et al. 2011

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“…We discovered that the PT was supplied by one or two motor nerve branches; however, more cases had one motor branch than two. Some authors have reported the motor point, which is the location where the nerve enters the muscle belly (Lee et al, 2011). We considered that of more than one motor point was found in <0.5 cm area, it was considered one motor point because of spreading agent.…”

Section: Resultsmentioning

confidence: 99%

Median Nerve Location Change Evaluated by Soft Cadaver Dissection According to the Forearm Movement

et al. 2016

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SUMMARY:The aim of this study was to examine the change in median nerve location according to forearm movement. Thirty fresh specimens from 15 adult Korean cadavers (10 males and five females; age range, 53-91 years) were examined. We measured the motor entry point according to normal and pronated positions of the forearm. The x and y coordinates of the first motor entry point (MEP) in the normal position were 1.6±0.6 cm and 2.8±1.3 cm, respectively. The depth of the MEP was 1.5±0.3 cm. The x and y coordinates of the second MEP were 1.3±0.3 cm and 4.7±1.7 cm, respectively. The depth of the MEP was 1.4±0.2 cm. The x and y coordinates of first MEP with the forearm in the pronated position were 1.9±0.7 cm and 2.3±0.8 cm. respectively. The depth of the MEP was 1.7±0.4 cm. The x and y coordinates of the second MEP were 1.6±0.7 cm and 4.4±1.7 cm, respectively. The depth of the MEP was 1.6±0.3 cm. The differences in locations according to movement of the nerve branch were 0.3 cm, and depths were 0.2 cm. The pronated position results of this study will be clinically helpful.

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“…Lee et al () reported that there were 3 (7.7%), 21 (53.8%), and 15 (38.5%) cases of 1, 2, and 3 nerve entry points, respectively, in the fibularis longus. For the fibularis brevis, there were 14 (35.9%), 21 (53.8%), and 4 (10.3%) cases of 1, 2, and 3 nerve entry points, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…This nerve begins near the fibular head and runs through the fibularis muscles. After supplying the motor component, the nerve provides cutaneous innervations to the lower one third on the lateral side of the leg (Rainoldi et al, ; Lee et al, ; Fracol et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Guideline for Botulinum Toxin Injections in the Effective Treatment of Fibular Spasticity

et al. 2019

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This study used a modified Sihler's staining method to analyze the nerve distributions of the fibularis muscle to identify the most effective sites for botulinum toxin injection for fibular spasticity treatment. Ten specimens of the fibularis longus and brevis were obtained bilaterally from five fixed cadavers. The applied method of modified Sihler's staining was designed to reveal the intramuscular nerve distribution of the fibularis muscles. We divided the fibularis muscles into four quarters, which were defined as Sections 1–4 starting from the proximal part of the leg. There were one, two, and three nerve entry points in one (10%), six (60%), and three (30%) of the fibularis longus specimens, respectively, and in four (40%), five (50%), and one (10%) of the fibularis brevis specimens, respectively. We counted the number of nerve endings in each section: 321 and 195 points were identified in the fibularis longus and brevis, respectively. The densities of nerve endings were highest in Section 2 of the fibularis longus (147 of 321, 46%) and in Section 3 of the fibularis brevis (78 of 195, 40%). The landmarks used in this study (the fibular head and lateral malleolus) are easily palpable on the skin's surface, allowing clinicians to target the effective injection site (Section 2) without requiring ultrasound guidance, especially for the fibularis longus. Clin. Anat. 33:365–369, 2020. © 2019 Wiley Periodicals, Inc.

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Anatomic localization of motor entry point of superficial peroneal nerve to peroneus longus and brevis muscles

Cited by 29 publications

References 21 publications

Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning

Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning

Median Nerve Location Change Evaluated by Soft Cadaver Dissection According to the Forearm Movement

Guideline for Botulinum Toxin Injections in the Effective Treatment of Fibular Spasticity

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