Intramuscular innervations of muscle flaps that are commonly used in clinical settings

Yu, Dazhi; Liu, Antang; Ruishan, Dang; Zhang, Chuansen; Zhang, Jianlin; Chen, Gang; Yi, Jing; Han, Tong; Jiang, Hua

doi:10.1007/s00276-010-0644-2

Cited by 14 publications

(17 citation statements)

References 25 publications

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“…Similar to two Chinese cadaveric studies by Boo-Chai, [1984] [24] and Yu et al, [2010] [25] , the majority of the specimens demonstrated a single branch coursing deep to the Sartorius muscle proximally with some specimens having 2 to 3 subbranches to the muscle. However, 21.43%, of our specimens had 2-3 twigs arising directly from the anterior branch and coursing deep to the muscle.…”

Section: Branching Patternssupporting

confidence: 80%

Surgical anatomy of the femoral nerve in formalin prefixed cadavers in an adult Kenya population

Alex¹,

Ayumba²,

El-badawi³

2022

Int. J. Orthop. Sci.

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Background: Ethnic variations involving femoral nerve have been described in literature. This nerve is the largest branch of the lumbar plexus. It innervates the hip flexors, knee extensors, and sensory function to medial and anterior aspects of the thigh. Risks of insults to nerve can be non-iatrogenic (trauma), and iatrogenic (approaches to the acetabulum, pelvis and proximal femur). The study aimed at providing precise description of variant anatomy of nerve, hence will help surgeons avoid iatrogenic insults. Methods: An anatomic descriptive cross-sectional study design involving fifty six (56), formalin prefixed adult cadaveric specimens. The length of the femoral nerve in relation to the inguinal ligament and its bony attachments, and the patterns of distribution of main branches in the regions were defined. Results: Males-35 (Left=17, Right=18); Females-21(Left=7, Right=14). Femoral nerve location: 53.02 mm (SD 14.59) from the ipsilateral anterior superior iliac spine (ASIS). Nerve trunk in relation to inguinal ligament measured: 47.85mm (SD 13.719) from the psoas muscle proximally and branched 29.32 mm (SD 14.239) distally. Innervations and branches: quadriceps in all specimens (Posterior); Sartorius muscles (Anterior), with noted variability in individual muscles. Branching pattern variations: 6 limbs (10.71%) at ligament level, 2(3.57%) limbs more proximal, while one nerve was split by a slip from the psoas muscle and then united 25.88mm proximal to ligament. The variations in sex were not statistically significant (p> 0.05). Conclusion:The anatomical course, length and branches of the femoral nerve in relation to inguinal ligament concur to great extent with described anatomic studies with some noted variability. Surgeons should be aware of the anatomic variations of femoral nerve and be cautious when operating in the zones traversed by the nerve.

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Section: Branching Patternssupporting

confidence: 80%

Surgical anatomy of the femoral nerve in formalin prefixed cadavers in an adult Kenya population

Alex¹,

Ayumba²,

El-badawi³

2022

Int. J. Orthop. Sci.

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“…Each compartment has its own muscle fiber direction and unique sites of origins and endings that distinguishes it from the other compartment. Each compartment has an independent function that can be separated as a flap in surgery [18]. The main nerve was divided into many minor branches after entering the superficial and deep heads; these minor branches were densely distributed at the middle area of the two heads, if we transfer each one of the heads in reconstructive operation, it could obtain good muscle contraction.…”

Section: Discussionmentioning

confidence: 99%

The Study of Intramuscular Nerve Distribution Patterns and Relative Spindle Abundance of the Thenar and Hypothenar Muscles in Human Hand

et al. 2012

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BackgroundThe intramuscular nerve distribution and relative spindle abundance of the human hand have not been well defined, although this is important in guiding hand surgery.MethodsForty human hands were dissected and subjected to modified Sihler’s stain and haematoxylin and eosin stain to investigate intramuscular nerve distribution and relative spindle abundance, respectively.ResultsThe flexor pollicis brevis (FPB), adductor pollicis (AP), and abductor digiti minimi (ADM) contain separate nerve compartments. Neural anastomoses were observed in the thenar and hypothenar muscles, including the Y-like, O-like, H-like, and U-like appearance. We found that U-like neural anastomoses may be the characteristic of the opponens muscles. The relative spindle abundance was the greatest in the opponens muscles which may coordinate fine movements.ConclusionExcept for the two opponens muscles, the rest of the thenar and hypothenar muscles could be used as whole muscle or half-muscle donors for muscle transplant. Our nerve map of the hand offers valuable guidance for hand reconstruction.

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“…The muscle acts as the shoulder extensor, adductor and internal rotator. The nerve supply is via the thoracodorsal nerve running deep to the muscle [48,49].…”

Section: Discussionmentioning

confidence: 99%

Intramuscular Neural Arborization of the Latissimus Dorsi Muscle: Application of Botulinum Neurotoxin Injection in Flap Reconstruction

Lee

Seo³

et al. 2022

Toxins

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Postoperative pain after breast reconstruction surgery with the latissimus dorsi flap is a common occurrence. Botulinum neurotoxin (BoNT) injection during surgery is effective in reducing postoperative pain. This study aimed to determine the most appropriate locations for BoNT injection. A modified Sihler’s method was performed on the latissimus dorsi muscles in 16 specimens. Intramuscular nerve arborization was noted under the landmark of the medial side surgical neck of the humerus to the line crossing the spinous process of T5 and the middle of the iliac crest. The latissimus dorsi muscles were divided into medial, middle, and lateral segments with 10 transverse divisions to give 10 sections (each 10%). Intramuscular nerve arborization of the latissimus dorsi muscle was the largest from the medial and lateral part of the muscle ranging from 40 to 60%, middle part from 30 to 60% and medial, middle and lateral part from 70 to 90%. The nerve entry points were at the medial and lateral part with 20–40% regarding the medial side of surgical neck of the humerus to the line crossing spinous process of T5 to the middle of iliac crest. These outcomes propose that an injection of BoNT into the latissimus dorsi muscles should be administered into specific zones.

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Intramuscular innervations of muscle flaps that are commonly used in clinical settings

Abstract: The six muscles are divided into several compartments by the tendon or nerve branches, and all of them make good donor tissue for muscle compartment transfer in reconstructive surgery.

Cited by 14 publications

References 25 publications

Surgical anatomy of the femoral nerve in formalin prefixed cadavers in an adult Kenya population

Surgical anatomy of the femoral nerve in formalin prefixed cadavers in an adult Kenya population

The Study of Intramuscular Nerve Distribution Patterns and Relative Spindle Abundance of the Thenar and Hypothenar Muscles in Human Hand

Intramuscular Neural Arborization of the Latissimus Dorsi Muscle: Application of Botulinum Neurotoxin Injection in Flap Reconstruction

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