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Anatomic motor point localization for partial quadriceps block in spasticity
1Service de Rééducation et de Réadaptation Fonctionnelles, Hôpital Fernand Widal, Paris.
Objective:
To identify the location of the vastus intermedius nerve and its motor point (point M) and to precisely identify its coordinates in relation to anatomic surface landmarks.
Design:
Descriptive study.
Setting:
Anatomy institute of a university school of medicine.
Participants:
Twenty-nine adult cadaver limbs immobilized in anatomic position.
Intervention:
Anatomic dissection to identify point M. Anatomic surface landmarks were point F, the issuing point of femoral nerve under the inguinal ligament; point R, the middle of superior edge of the patella; segment FR, which corresponds to thigh length; point M', point M orthogonal projection on segment FR.
Mean Outcome Measure:
Absolute vertical coordinate, distance FM, relative vertical coordinate compared to the thigh length, FM'/FR ratio; absolute horizontal coordinate, distance MM'.
Results:
The absolute vertical coordinate was 11.7+/-2 cm. The relative vertical coordinate was at .29+/-.04 of thigh length. The horizontal coordinate was at 2+/-.5 cm lateral to the FR line.
Conclusion:
Point M can be defined with relative precision by two coordinates. Application and clinical interest of nerve blocking using these coordinates in quadriceps spasticity should be studied.