Using the nerve entry points to localize the nerve block targets of the triceps surae muscle spasticity
HU Shuai-yu, ZHUO Li-fan YANG Sheng-bo
Chinese Journal of Clinical Anatomy ›› 2017, Vol. 35 ›› Issue (1) : 15-18.
Using the nerve entry points to localize the nerve block targets of the triceps surae muscle spasticity
Objective To investigate the location of nerve entry point (N point) of the triceps surae accurately in order to provide the anatomical basis for the clinical nerve block of this muscle spasticity. Methods Twenty sides of lower limbs of 10 adult cadavers were dissected and exposed in the prone position. The lines on the skin between the lateral epicondyle to the medial epicondyle of the femur and fro the lateral epicondyle of the femur to the lateral malleolus were designated as the horizontal reference line (H line) and the longitudinal reference line (L line) of the N point, respectively. Those cadavers were dissected to expose the point N of each nerve muscle branch of triceps surae for staining the N points by barium sulfate. CT scanning was performed. Syngo system was used to determine the body surface projection point (P point) of point N; P by N projecting to the contralateral limb skin was designated as P'; The intersections the vertical line through P and the H line, the horizontal line through P and line L were designated as PH and PL, respectively. The percentage location of PH and PL points on H line and L line and depth of point N were measured, respectively. Results The point PH of the medial head of gastrocnemius, lateral head of gastrocnemius and soleus were located at（46.89±2.73）%, （40.90±3.05）% and（42.56±2.59）% of the H line, respectively, and at （7.58±2.88）%, （8.15±2.52）% and （17.42±3.31）% of the L line, respectively; The depth of N points after P points were located at（16.32±2.52）%, （13.83±1.77）% and（29.93±2.89）%, respectively. Conclusion These parameters can improve the efficacy and efficiency of the neurolysis for the treatment of triceps muscle spasticity.
Triceps surae muscle / Muscle spasticity / Nerve entry points / Localization / Nerve block
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