Annals of Rehabilitation Medicine

"Hyun Jung Koo"

Original Article

Safe Needle Insertion Locations for Motor Point Injection of the Triceps Brachii Muscle: A Pilot Cadaveric and Ultrasonography Study: Hyun Jung Koo, Hye Jung Park, Geun-Young Park, Yeonjae Han, Donggyun Sohn, Sun Im; Ann Rehabil Med 2019;43(6):635-641. Published online December 31, 2019; DOI: https://doi.org/10.5535/arm.2019.43.6.635

Abstract
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Objective
To determine the location of the motor endplate zones (MoEPs) for the three heads of the triceps brachii muscles during cadaveric dissection and estimate the safe injection zone using ultrasonography.
Methods
We studied 12 upper limbs of 6 fresh cadavers obtained from body donations to the medical school anatomy institution in Seoul, Korea. The locations of MoEPs were expressed as the percentage ratio of the vertical distance from the posterior acromion angle to the midpoint of the olecranon process. By using the same reference line as that used for cadaveric dissection, the safe injection zone away from the neurovascular bundle was identified in 6 healthy volunteers via ultrasonography. We identified the neurovascular bundle and its location with respect to the distal end of the humerus and measured its depth from the skin surface.
Results
The MoEPs for the long, lateral, and medial heads were located at a median of 43.8%, 54.8%, and 60.4% of the length of the reference line in cadaver dissection. The safe injection zone of the medial head MoEPs corresponded to a depth of approximately 3.5 cm from the skin surface and 1.4 cm away from the humerus, as determined by sonography.
Conclusion
Correct identification of the motor points for each head of the triceps brachii would increase the precision and efficacy of motor point injections to manage elbow extensor spasticity.

Citations

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Enhancing Botulinum Toxin Injection Precision: The Efficacy of a Single Cadaveric Ultrasound Training Intervention for Improved Anatomical Localization
Camille Heslot, Omar Khan, Alexis Schnitzler, Chloe Haldane, Romain David, Rajiv Reebye
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Distribution of the intramuscular innervation of the triceps brachii: Clinical importance in the treatment of spasticity with botulinum neurotoxin
Kyu‐Ho Yi, Ji‐Hyun Lee, Hye‐Won Hur, Hyung‐Jin Lee, You‐Jin Choi, Hee‐Jin Kim
Clinical Anatomy.2023; 36(7): 964. CrossRef
Mapping the limb muscle motor points for targeted administration of botulinum toxin in the treatment of focal and segmental spasticity
A. P. Kovalenko, K. A. Sinelnikov, V. D. Shamigulov, N. N. Akhmedov, E. M. Shamina
Neurology, Neuropsychiatry, Psychosomatics.2020; 12(6): 61. CrossRef

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Case Report

Lipoma Compressing the Sciatic Nerve in a Patient With Suspicious Central Post-stroke Pain: Ju Yong Kim, Hyun Jung Koo, Geun-Young Park, Yongmin Choi; Ann Rehabil Med 2017;41(3):488-492. Published online June 29, 2017; DOI: https://doi.org/10.5535/arm.2017.41.3.488

Abstract
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Lipomas are mostly located in the subcutaneous tissues and rarely cause symptoms. Occasionally, peripheral nerve compression by lipomas is reported. We describe a case of a 59-year-old man with a left-middle cerebral artery infarction who was newly diagnosed as right basal ganglia and thalamic intracranial hemorrhage. He had neuropathic pain in the left arm and leg that was suspected to be central post-stroke pain. The administration of pain medication brought only temporary symptom relief. Nerve conduction and electromyography studies revealed left L5 radiculopathy and he showed a positive ‘sign of the buttock’ in the left hip. Left-hip magnetic resonance imaging revealed an intermuscular lipoma compressing the sciatic nerve. After surgery, the range of motion in the left hip joint was significantly increased, and the patient's pain was relieved.

Citations

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Intrafat Sequestration of Artemisinin Disguised as a Purulent Collection during a Posterolateral Hip Approach
Atchi Walla, Batomayena Bakoma, Pilakimwé Egbohou
Case Reports in Orthopedics.2019; 2019: 1. CrossRef