Optimal injection points for the neuromuscular blockade of forearm flexor muscles: a cadaveric study.
Botulinum toxin acts at neuromuscular junctions close to muscle motor points and is used to help manage spastic upper-limb deformities. To develop a system allowing clinicians to identify optimal injection sites by an easily reproducible technique, forearm flexor muscles were dissected in 20 formalin-preserved human limbs. Motor points for flexor carpi ulnaris, flexor carpi radialis, flexor digitorum superficialis and pronator teres were (1) identified, (2) related to a reference grid based on lines (proximal, distal, lateral, medial and diagonals) drawn between forearm anatomical landmarks, and (3) defined in terms of their percentage distances along the established grid lines.
Roberts
Charles
C
Department of Anatomy, University College London bThe Royal National Orthopaedic Hospital, London, UK.
Crystal
Roger
R
Eastwood
Deborah M
DM
D018726:Anti-Dyskinesia Agents / Q000008:administration & dosage; D001905:Botulinum Toxins / Q000008:administration & dosage; D002102:Cadaver; D004421:Dystonia / Q000188:drug therapy; D005260:Female; D005542:Forearm / Q000033:anatomy & histology*; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods* / Q000592:standards; D008297:Male; D008475:Median Nerve / Q000033:anatomy & histology; D018482:Muscle, Skeletal / Q000294:innervation*; D019148:Neuromuscular Blockade / Q000379:methods*
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins