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Intramuscular innervations of lower leg skeletal muscles: applications in their clinical use in functional muscular transfer

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Abstract

Purpose

This study aims to investigate nerve distribution patterns of human lower leg skeletal muscles using a modified Sihler’s staining method.

Methods

Sixteen lower leg from eight fresh adult cadavers were used in this study and all the skeletal muscles were dissected. The muscle specimens were classified according to Lim’s classification. The specimens were then stained by further modified Sihler’s staining technique. Data were analyzed according to research results.

Results

After the staining, we found four patterns of nerve distribution in human lower leg muscles: (1) Type 1: single nerve pattern in which the nerve branches into two either running parallel to each other or radiating in a spray pattern (such as the extensor digitorum longus, extensor hallucis longus, fibularis brevis and flexor hallucis longus). (2) Type 2: double nerve pattern, one being proximal and the other being distal (such as the extensor digitorum longus, flexor digitorum longus, flexor hallucis longus). (3) Type 3: multiple branch pattern (such as the tibialis anterior, fibularis longus, gastrocnemius, soleus, tibialis anterior and popliteus).

Conclusion

Our modified Sihler’s staining method is useful for research of large muscles and intramuscular nerves in human. These findings might provide guidance for clinicians for muscle reconstruction surgery.

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Acknowledgments

The research was supported by the General Financial Grant from the China Postdoctoral Science Foundation (2014M562659).

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Author notes

    Authors and Affiliations

    1. Department of Orthopedic and Traumatic Surgery, General Hospital of Jinan Military Command, No. 25 Shi Fan Road, Tianqiao District, Jinan, 250031, China

      Dazhi Yu & Xuecheng Cao

    2. Department of Hand Surgery, No. 401 Hospital of the People’s Liberation Army (PLA), Qingdao, 266071, China

      Dazhi Yu

    3. Department of Plastic Surgery, Changzheng Hospital, Second Military Medical University, No. 415 Feng Yang Road, Shanghai, 200003, China

      Dazhi Yu, Tong Han & Hua Jiang

    4. Department of Orthopedic and Traumatic Surgery, No. 401 Hospital of the People’s Liberation Army (PLA), Qingdao, 266071, China

      Hailei Yin

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    1. Dazhi Yu
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    Correspondence to Hua Jiang or Xuecheng Cao.

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    The authors of this manuscript declare no conflict of interest to disclose.

    Authors’ contribution

    H Jiang and X. Cao do the work of study design and funds collection; D. Yu and H. Yin contribute to data collection, manuscript preparation, and literature search. T. Han performs statistical analysis and data interpretation.

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    D. Yu and H. Yin contributed equally to this work.

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    Yu, D., Yin, H., Han, T. et al. Intramuscular innervations of lower leg skeletal muscles: applications in their clinical use in functional muscular transfer. Surg Radiol Anat 38, 675–685 (2016). https://doi.org/10.1007/s00276-015-1601-x

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    • DOI: https://doi.org/10.1007/s00276-015-1601-x

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