Yi Kyu-Ho, Lee Ji-Hyun, Hur Hye-Won, Lee Hyung-Jin, Choi You-Jin, Kim Hee-Jin
Wonju Public Health Center, Wonjusi, Republic of Korea.
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Republic of Korea.
Clin Anat. 2023 Oct;36(7):964-970. doi: 10.1002/ca.24004. Epub 2023 Jan 18.
This study aimed to identify ideal sites for botulinum toxin injection by analyzing the intramuscular nerve patterns of the triceps brachii muscles. A modified Sihler's method was applied to the triceps brachii muscle (15 specimens), with long, medial, and lateral heads. The intramuscular arborization areas of the long, medial, and lateral heads of the triceps brachii muscle were measured as a percentage of the total distance from the midpoint of the olecranon (0%) to the anteroinferior point of the acromion (100%), by dividing the medial and lateral parts based on the line connecting the midpoint of the olecranon and the anteroinferior point of the acromion. Intramuscular arborization patterns were observed at the long head at two medial regions, proximally 30%-50% and distally 60%-70%; medial head of 30%-40%; and lateral head of 30%-60%. These results suggest that the treatment of spasticity of the triceps brachii muscles involves botulinum toxin injections in specific areas. The areas corresponding to the areas of maximum arborization are recommended as the most effective and safe points for botulinum toxin injection.
本研究旨在通过分析肱三头肌的肌内神经模式来确定肉毒杆菌毒素注射的理想部位。改良的席勒氏方法应用于肱三头肌（15个标本），包括长头、内侧头和外侧头。通过基于连接鹰嘴中点和肩峰前下点的线划分内侧和外侧部分，测量肱三头肌长头、内侧头和外侧头的肌内分支区域，以其占从鹰嘴中点（0%）到肩峰前下点（100%）总距离的百分比表示。在长头的两个内侧区域观察到肌内分支模式，近端为30%-50%，远端为60%-70%；内侧头为30%-40%；外侧头为30%-60%。这些结果表明，肱三头肌痉挛的治疗涉及在特定区域注射肉毒杆菌毒素。建议将与最大分支区域相对应的区域作为肉毒杆菌毒素注射最有效和安全的点。
