Intramuscular nerve distribution pattern of ankle invertor muscles in human cadaver using sihler stain |
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| Authors: | Kyu‐Ho Yi PT Dong‐Wook Rha MD PhD Sang Chul Lee MD PhD Liyao Cong MS Hyung‐Jin Lee MS Yong‐Woong Lee Hee‐Jin Kim DDS PhD Kyung‐Seok Hu DDS PhD |
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| Affiliation: | 1. Division in Anatomy and Developmental Biology, Room 601, Department of Oral Biology, Yonsei University College of Dentistry, Seodaemun‐gu, Seoul, South Korea;2. Department and Research Institute of Rehabilitation Medicine, Severance Rehabilitation Hospital, Yonsei University College of Medicine, Seoul, Korea |
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| Abstract: | Introduction: We sought to the ideal sites for botulinum toxin injection by examining the intramuscular nerve patterns of the ankle invertors. Methods: A modified Sihler method was performed on the flexor hallucis longus, tibialis posterior, and flexor digitorum longus muscles (10 specimens each). The muscle origins, nerve entry points, and intramuscular arborization areas were measured as a percentage of the total distance from the most prominent point of the lateral malleolus (0%) to the fibular head (100%). Results: Intramuscular arborization patterns were observed at 20–50% for the flexor hallucis longus, 70–80% for the tibialis posterior, and 30–40% for the flexor digitorum longus. Conclusions: These findings suggest that treatment of muscle spasticity of the ankle invertors involves botulinum toxin injections in specific areas. These areas, corresponding to the areas of maximum arborization, are recommended as the most effective and safest points for injection. Muscle Nerve 53 : 742–747, 2016 |
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| Keywords: | botulinum toxin flexor hallucis longus flexor digitorum longus Sihler method spasticity tibialis posterior |
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