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Intramuscular nerve distribution pattern of ankle invertor muscles in human cadaver using sihler stain.

Authors
 KYU-HO YI  ;  DONG-WOOK RHA  ;  SANG CHUL LEE  ;  LIYAO CONG  ;  HYUNG-JIN LEE  ;  YONG-WOONG LEE  ;  HEE-JIN KIM  ;  KYUNG-SEOK HU 
Citation
 Muscle & Nerve, Vol.53(5) : 742-747, 2016 
Journal Title
 Muscle & Nerve 
ISSN
 0148-639X 
Issue Date
2016
MeSH
Acetylcholine Release Inhibitors/administration & dosage ; Adult ; Aged ; Aged, 80 and over ; Ankle* ; Botulinum Toxins/administration & dosage ; Cadaver ; Coloring Agents ; Female ; Humans ; Male ; Middle Aged ; Muscle Spasticity/drug therapy ; Muscle, Skeletal/innervation* ; Peripheral Nerves/anatomy & histology*
Keywords
Sihler method ; botulinum toxin ; flexor digitorum longus ; flexor hallucis longus ; spasticity ; tibialis posterior
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.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/mus.24939/abstract
DOI
10.1002/mus.24939
Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Oral Biology (구강생물학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hee Jin(김희진) ORCID logo https://orcid.org/0000-0002-1139-6261
Rha, Dong Wook(나동욱) ORCID logo https://orcid.org/0000-0002-7153-4937
Lee, Sang Chul(이상철) ORCID logo https://orcid.org/0000-0002-6241-7392
Hu, Kyung Seok(허경석) ORCID logo https://orcid.org/0000-0002-9048-3805
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/147135
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