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Extramuscular nerve block targets localization for the treatment of spasticity of the medial group of the muscles of the thigh
HU Shuang-jiang TIAN Xu-feng ZHANG Yong YANG Sheng-bo *
Acta Anatomica Sinica ›› 2015, Vol. 46 ›› Issue (4) : 532-537.
Extramuscular nerve block targets localization for the treatment of spasticity of the medial group of the muscles of the thigh
Objective To determine the precise location of extramuscular nerve block targets of thigh adductor muscles. Methods A horizontal reference line (line H) was designed from the pubic tubercle to the skin lateral to the greater trochanter of the femur. Another longitudinal reference line (line L) was designed from the pubic tubercle to the level of the medial epicondyle of the femur. The obturator nerve and its muscular branches were dissected and exposed in 10 formalin fixed adult cadavers (20 sides). The nerves were coated barium sulfate on the surface and air-dried, X-ray radiography was performed. The percent positions of extramuscular nerve block targets of muscular branches of obturator nerve on line H and L were measured by PACS software. Results The proximal motor point (point P) of the gracilis branch, adductor longus branch, adductor brevis branch and adductor magnus branch of the obturator nerve were located at (21.48±1.80)%, (25.85 ± 1.23)%, (28.07 ± 1.65)% and (29.18 ± 2.07)% of the lateral of pubic tubercle along thigh width (line H) respectively; at (8.83 ± 1.01)%, (8.83 ± 1.01)%, (7.57 ± 0.63)% and (7.57 ± 0.63)% of the distal of pubic tubercle along thigh length (line L) respectively. The distal motor points (points D) were located at (16.9 ± 1.33)%, (27.70 ± 2.15)%, (31.18 ± 2.18)% and (35.78 ± 2.79)% of the lateral of pubic tubercle along thigh width (line H) respectively; at (35.57 ± 2.77)%, (26.9 ± 1.96) %, (24.26 ± 1.91)% and (28.04 ± 2.17)% of the distal of pubic tubercle along thigh length (line L) respectively. Conclusion Precise location of these targets can improve the safety and effectiveness for blocking the extramuscular nerve targets in medial femoral muscles spasticity.
Medial femoral muscle / Muscle spasticity / Obturator nerve muscular branche / Target localization / X-ray radiography / Adult
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