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. 2021 Dec;43(12):2025-2030.
doi: 10.1007/s00276-021-02813-7. Epub 2021 Aug 11.

Anatomical locations of the motor endplates of sartorius muscle for botulinum toxin injections in treatment of muscle spasticity

Kyu-Ho Yi #  1   2 , Ji-Hyun Lee #  2 , Dongkeun Kenneth Lee  3 , Hye-Won Hu  2 , Kyle K Seo  4 , Hee-Jin Kim  5   6
Affiliations

Anatomical locations of the motor endplates of sartorius muscle for botulinum toxin injections in treatment of muscle spasticity

Kyu-Ho Yi et al. Surg Radiol Anat. 2021 Dec.

Abstract

Purpose: This study aimed to detect the idyllic locations for botulinum neurotoxin injection by analyzing the intramuscular neural distributions of the sartorius muscles.

Methods: An altered Sihler's staining was conducted on sartorius muscles (15 specimens). The nerve entry points and intramuscular arborization areas were measured as a percentage of the total distance from the most prominent point of the anterior superior iliac spine (0%) to the medial femoral epicondyle (100%).

Results: Intramuscular neural distribution were densely detected at 20-40% and 60-80% for the sartorius muscles. The result suggests that the treatment of sartorius muscle spasticity requires botulinum neurotoxin injections in particular locations.

Conclusions: These locations, corresponding to the locations of maximum arborization, are suggested as the most suggestive points for botulinum neurotoxin injection.

Keywords: Botulinum neurotoxin; Sartorius muscle; Sihler’s staining; Spasticity.

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Conflict of interest statement

I acknowledge that I have considered the conflict of interest statement included in the “Author Guidelines.” I hereby certify that, to the best of my knowledge, that no aspect of my current personal or professional situation might reasonably be expected to significantly affect my views on the subject I am presenting.

Figures

Fig. 1
Fig. 1
Sartorius muscles were harvested from the anterior superior iliac spine (ASIS) (0%) to the medial femoral epicondyle (MFE) (100%)
Fig. 2
Fig. 2
The sartorius muscle underwent modified Sihler’s staining. The method consists of the procedures of fixation (FX), maceration and depigmentation (MD), decalcification, staining (ST), and clearing (CL)
Fig. 3
Fig. 3
A Sihler’s-stained sartorius muscle with enlarged images of intramuscular neural distributions. Intramuscular nerve pattern and entry points were revealed by dissection and staining
Fig. 4
Fig. 4
Recommendation for electromyography or BoNT injection of the sartorius muscle. The ultimate suggestions were achieved in relatively to the anterior superior iliac spine to the medial femoral epicondyle. The sartorius muscles demonstrated arborization neural distribution at 20–40% and 60–80% (yellow boxes)
See this image and copyright information in PMC

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