Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea.
Department of Anatomy, Daegu Catholic University School of Medicine, Daegu, Korea.
Yonsei Med J. 2023 Aug;64(8):511-517. doi: 10.3349/ymj.2023.0124.
Anatomical landmarks can provide vital information on the distribution of nerves in the gastrocnemius muscle. We aimed to provide an anatomical perspective on appropriate locations for botulinum neurotoxin (BoNT) injections in the medial and lateral parts of the gastrocnemius for calf shaping.
A modified Sihler's method was applied to both the medial and lateral parts of the gastrocnemius muscles (16 specimens). Intramuscular neural distributions were revealed by dissecting along a transverse line crossing the fibular head and superior margin of the calcaneal tuberosity.
The intramuscular neural distribution for the medial and lateral parts of the gastrocnemius had the greatest arborized patterns in the 7/10-8/10 section of the medial head and 7.5/10-8.5/10 section of the lateral part of the gastrocnemius.
We propose that BoNT injections should be directed to the 7/10-8/10 section of the medial head and the 7.5/10-8.5/10 section of the lateral part of the gastrocnemius. Following our guidelines, clinicians can ensure satisfactory results with the use of minimal doses to limit adverse effects, such as gait disturbance, antibody production, and bruising, due to multiple injections. The results can also be altered and applied to electromyography.
解剖学标志可以提供关于腓肠肌中神经分布的重要信息。我们旨在从解剖学角度探讨在腓肠肌内侧和外侧适合注射肉毒毒素（BoNT）的位置，以达到小腿塑形的目的。
对腓肠肌的内侧和外侧部分（16 个标本）应用改良的 Sihler 法。通过沿穿过腓骨头和跟骨结节上缘的横切线进行解剖，揭示肌内神经分布。
内侧和外侧腓肠肌的肌内神经分布在内侧头的 7/10-8/10 节段和外侧腓肠肌的 7.5/10-8.5/10 节段具有最大的分支模式。
我们建议 BoNT 注射应针对内侧头的 7/10-8/10 节段和外侧腓肠肌的 7.5/10-8.5/10 节段。根据我们的指南，临床医生可以使用最小剂量确保满意的效果，从而限制因多次注射引起的不良反应，如步态障碍、抗体产生和瘀伤。结果也可以进行改变并应用于肌电图。
