Neuromuscular structure of the tibialis anterior muscle for functional electrical stimulation

• Published in: Surgical and radiologic anatomy (English ed.) Vol. 39; no. 1; pp. 77 - 83
• Main Authors: Yi, Kyu-Ho, Cong, Liyao, Bae, Jung-Hee, Park, Eun-Sook, Rha, Dong-wook, Kim, Hee-Jin
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 2017; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Anatomy; Botulinum Toxins - administration & dosage; Cadaver; Dissection; Electric Stimulation - methods; Female; Humans; Imaging; Injections, Intramuscular - methods; Leg - anatomy & histology; Leg - innervation; Legs; Male; Medicine; Medicine & Public Health; Middle Aged; Muscle, Skeletal - anatomy & histology; Muscle, Skeletal - innervation; Muscular system; Nervous system; Original Article; Orthopedics; Radiology; Surgery; Spasticity; Sihler’s staining; Functional electrical stimulation; Tibialis anterior; Botulinum toxin
• ISSN: 0930-1038; 1279-8517
• DOI: 10.1007/s00276-016-1698-6

Purpose This study describes the nerve entry points and intramuscular nerve branching of the tibialis anterior, providing essential information for therapeutic functional electrical stimulation and botulinum toxin injection. Methods One hundred and ten legs from Korean and Thai cadavers were dissected. Ten specimens were harvested and subjected to modified Sihler’s staining. Results The average total length from the lateral malleolus to the fibular head was 32.0 cm (SD 1.9). The nerve entry points were densely distributed between 86.5 and 90.6 % of the reference length, where the first and second nerve entry points were observable. A densely arborizing area of the intramuscular nerve branches was observed at 70–80 % of the reference length. Conclusions Based on the results of this study, clinicians can increase the effectiveness of therapeutic functional electrical stimulation and identify the ideal sites for botulinum toxin injection to the tibialis anterior muscle.