Intramuscular Neural Distribution of Adductor Pollicis Muscle Spasticity in Cadaver Model Regarding Botulinum Neurotoxin Treatment

Yonsei Med J. 2023 Sep;64(9):581-585. doi: 10.3349/ymj.2023.0111.

Abstract

Purpose: The adductor pollicis muscle is frequently targeted for botulinum neurotoxin injective treatment for spasticity. However, there are no injective guidelines for delivering injection to the muscle.

Materials and methods: A method known as the modified Sihler's method was used to stain the adductor pollicis muscle in 16 specimens to reveal intramuscular neural distribution of the muscle.

Results: The most intramuscular neural distribution was located on 1/5 to 3/5 of the muscle regarding midline of 3rd metacarpal bone (0) to the base of the 1st proximal phalanx (5/5). The nerve entry point was mostly located on 0 to 1/5 of the muscle.

Conclusion: The result suggests that botulinum neurotoxin should be delivered at the middle of second metacarpal bone via deep injection.

Keywords: Adductor pollicis muscle; Sihler's method; botulinum neurotoxin; injection; intramuscular neural distribution; spasticity.

MeSH terms

  • Botulinum Toxins* / therapeutic use
  • Cadaver
  • Humans
  • Muscle Spasticity* / drug therapy
  • Muscles

Substances

  • Botulinum Toxins