Choi You-Jin, Filler Timm Joachim, Wolf-Vollenbröker Michael, Lee Ji-Hyun, Lee Hyung-Jin
Department of Anatomy, School of Medicine, Konkuk University, Chungju 27478, Republic of Korea.
Institute for Anatomy I, University Hospital Düsseldorf (UKD), Heinrich Heine University (HHU), 40225 Düsseldorf, Germany.
Diagnostics (Basel). 2024 Aug 7;14(16):1716. doi: 10.3390/diagnostics14161716.
This study aimed to elucidate the intramuscular distribution pattern of the medial plantar nerve and determine its motor nerve ending territories within the abductor hallucis muscle using modified Sihler's staining and external anatomical landmarks. The study included 40 specimens of the abductor hallucis muscle (13 men and seven women) from formalin-fixed (ten cadavers) and fresh cadavers (ten cadavers), with a mean age of 77.6 years. The entry point of the medial plantar nerve into the muscle was examined, followed by Sihler's staining to analyze the intramuscular distribution pattern and motor nerve ending location within the abductor hallucis muscle. Ultrasound- and palpation-guided injections were performed to verify the applicability of motor nerve ending location-based injections. The areas with the highest concentrations of nerve entry points and nerve endings were identified in the central portion of the muscle. Ultrasound- and palpation-guided injections were safely positioned near the densest nerve ending region of the muscle. These detailed anatomical data and injection methods would be beneficial for proceeding with safe and effective injection treatments using various analgesic agents to alleviate abductor hallucis muscle-associated pain disorders.
本研究旨在利用改良的西勒氏染色法和外部解剖标志，阐明足底内侧神经的肌内分布模式，并确定其在拇展肌内的运动神经末梢区域。该研究纳入了40例拇展肌标本（13例男性和7例女性），来自福尔马林固定的尸体（10具）和新鲜尸体（10具），平均年龄为77.6岁。检查了足底内侧神经进入肌肉的入口点，随后进行西勒氏染色，以分析拇展肌内的肌内分布模式和运动神经末梢位置。进行了超声引导和触诊引导注射，以验证基于运动神经末梢位置的注射的适用性。在肌肉中央部分确定了神经入口点和神经末梢浓度最高的区域。超声引导和触诊引导注射被安全地定位在肌肉最密集的神经末梢区域附近。这些详细的解剖学数据和注射方法将有助于使用各种镇痛剂进行安全有效的注射治疗，以缓解与拇展肌相关的疼痛障碍。
