title: Intramuscular innervations of lower leg skeletal muscles: applications in their clinical use in functional muscular transfer.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopedic and Traumatic Surgery, General Hospital of Jinan Military Command, No. 25 Shi Fan Road, Tianqiao District, Jinan, 250031, China.|Department of Hand Surgery, No. 401 Hospital of the People's Liberation Army (PLA), Qingdao, 266071, China.|Department of Plastic Surgery, Changzheng Hospital, Second Military Medical University, No. 415 Feng Yang Road, Shanghai, 200003, China.
authors.forename: Dazhi
authors.initials: D
authors.lastname: Yu
authors.affiliation: Department of Orthopedic and Traumatic Surgery, No. 401 Hospital of the People's Liberation Army (PLA), Qingdao, 266071, China.
authors.forename: Hailei
authors.initials: H
authors.lastname: Yin
authors.affiliation: Department of Plastic Surgery, Changzheng Hospital, Second Military Medical University, No. 415 Feng Yang Road, Shanghai, 200003, China.
authors.forename: Tong
authors.initials: T
authors.lastname: Han
authors.affiliation: Department of Plastic Surgery, Changzheng Hospital, Second Military Medical University, No. 415 Feng Yang Road, Shanghai, 200003, China. ydz1023@126.com.
authors.forename: Hua
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Orthopedic and Traumatic Surgery, General Hospital of Jinan Military Command, No. 25 Shi Fan Road, Tianqiao District, Jinan, 250031, China. drydz@126.com.
authors.forename: Xuecheng
authors.initials: X
authors.lastname: Cao
mesh_terms: D000328:Adult; D002102:Cadaver; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation*; D010525:Peripheral Nerves / Q000033:anatomy & histology*; D013194:Staining and Labeling / Q000379:methods; D013977:Tibia
keywords: Cadaver; Intramuscular innervation; Lower leg muscle; Muscle compartment