Intramuscular nerve distribution of the hamstring muscles: Application to treating spasticity

Rha, Dong-Wook; Yi, Kyu Ho; Park, Eun Sook; Park, Chunung; Kim, Hee Jin

doi:10.1002/ca.22735

Cited by 48 publications

(49 citation statements)

References 33 publications

(56 reference statements)

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“…Clinically, the target area for BoNT injection is at the midpoint of the muscle belly. However, intramuscular nerve distribution studies show a discrepancy within muscles, as discovered by Sihler staining in our previous studies of calf muscles, hip adductor muscles, and forearm muscles …”

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confidence: 71%

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Rha

Kim

et al. 2016

Muscle and Nerve

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confidence: 71%

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Rha

Kim

et al. 2016

Muscle and Nerve

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“…Furthermore, the necessity of recurrent intramuscular injections for treating shortened SCM, which is a chronic disease, can lead to the development of antibodies against the toxin. Therefore, attempting to prevent toxin resistance from antibody production by using smaller doses is an important consideration (Blackie and Lees, ; Anderson et al, ; Hambleton et al, ; Rha et al, ; Yi et al, ; Yi et al, ).…”

Section: Discussionmentioning

confidence: 99%

Effective botulinum toxin injection guide for treatment of cervical dystonia

Choi

Cong

et al. 2019

Clinical Anatomy

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The aim of this study was to elucidate the distribution of the accessory nerve within the sternocleidomastoid muscle (SCM) to aid identifying the optimum sites for botulinum neurotoxin (BoNT) injections and applying chemical neurolysis. Thirty SCM specimens from 15 Korean cadavers were used in this study. Sihler's staining was applied to 10 of the SCM specimens. Transverse lines were drawn in 20 sections to divide the SCM into 10 divisions vertically, and a vertical line was drawn into the medial and lateral halves from the mastoid process to the sternoclavicular joint. The most densely innervated areas were 5/10-6/10 and 6/10-7/10 along the lateral and medial parts of the muscle, respectively. We suggest injecting BoNT in the medial region 6/10-7/10 along the SCM prior to injecting in the lateral region 5/10-6/10 along the muscle to ensure safe and effective treatment. Clin. Anat. 33:192-198, 2020.

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“…Second, the anatomical motor point that was defined as the most distal point where the motor branch entered the muscle belly in this study may not reflect the end-plate zone. However, the term ‘motor point’ is occasionally to mean the location of the terminal portion of the motornerve fibers, or the end-plate zone [ 7 19 20 ]. Further large-scale and clinical studies are warranted to validate the average coordinates of the motor points.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Localization of Motor Points of the Abductor Hallucis Muscle: A Cadaveric Study

et al. 2017

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ObjectiveTo identify the anatomical motor points of the abductor hallucis muscle in cadavers.MethodsMotor nerve branches to the abductor hallucis muscles were examined in eight Korean cadaver feet. The motor point was defined as the site where the intramuscular nerve penetrates the muscle belly. The reference line connects the metatarsal base of the hallux (H) to the medial tubercle of the calcaneus (C). The x coordinate was the horizontal distance from the motor point to the point where the perpendicular line from the navicular tuberosity crossed the reference line. The y coordinate was the perpendicular distance from the motor point to the navicular tuberosity.ResultsMost of the medial plantar nerves to the abductor hallucis muscles divide into multiple branches before entering the muscles. One, two, and three motor branches were observed in 37.5%, 37.5%, and 25% of the feet, respectively. The ratios of the main motor point from the H with respect to the H-C line were: main motor point, 68.79%±5.69%; second motor point, 73.45%±3.25%. The mean x coordinate value from the main motor point was 0.65±0.49 cm. The mean value of the y coordinate was 1.43±0.35 cm. All of the motor points of the abductor hallucis were consistently found inferior and posterior to the navicular tuberosity.ConclusionThis study identified accurate locations of anatomical motor points of the abductor hallucis muscle by means of cadaveric dissection, which can be helpful for electrophysiological studies in order to correctly diagnose the various neuropathies associated with tibial nerve components.

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Intramuscular nerve distribution of the hamstring muscles: Application to treating spasticity

Cited by 48 publications

References 33 publications

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Effective botulinum toxin injection guide for treatment of cervical dystonia

Anatomical Localization of Motor Points of the Abductor Hallucis Muscle: A Cadaveric Study

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