Innervation of the subscapularis muscle and implications for treatment of spasticity.

IF 1.2 4区医学 Q2 Medicine

Surgical and Radiologic Anatomy Pub Date : 2026-10-09 DOI:10.1007/s00276-026-04014-6

Pierre Maincourt, Brahman Sivakumar, Anne Perruisseau-Carrier

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Abstract

Background: Spasticity of the muscles in the shoulder girdle, frequently observed in upper motor neuron syndromes, leads to an internal rotation deformity with associated functional limitation. Selective neurectomy (SN) of motor branches can offer targeted relief whilst preserving glenohumeral joint stability.

Objective: To provide detailed anatomical mapping of motor branches to the subscapularis muscle and assess the feasibility of SN in the management of shoulder spasticity.

Methods: Twenty shoulders from ten formalin-fixed cadavers were dissected via an infraclavicular approach. The number, diameter, length of the motor branches were documented, as was the distance of the emergence point of the nerves referenced from the inferior border of the clavicle. Anatomical variations were recorded.

Results: The mean number of motor branches to the subscapularis was 2.55 (± 0.89). The average length of each branch was 44.9 mm, with an average diameter of 1.9 mm. Branches emerged on average 36 mm below the inferior edge of the clavicle, with 7.9% emerging more proximally. An origin from the axillary nerve was identified in 35% of cadavers, typically supplying the lower segment of the muscle. A common trunk with the thoracodorsal nerve was observed in 10% of dissections.

Conclusion: This study provides an anatomical map of the innervation to the subscapularis, with a mean of 2.55 branches emerging on average 36mm below the inferior edge of the clavicle. This information is useful when considering performing selective neurectomy to this muscle in the setting of upper motor neuron syndrome.

Level of evidence iv:

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肩胛下肌的神经支配及其痉挛治疗的意义。

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.