Recommendation of the Best Site Based on the Distribution Pattern of Extramuscular and Intramusular Nerves for Gluteal Muscle Injection

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Junxi Wu; Yanzhen Cai; Ai Cao; Yu Bi; Xiangnan Hu & Shengbo Yang


To reveal the extra- and intramuscular nerve distribution patterns of the gluteus maximus, medius, and minimus, and to provide guidance for gluteal muscle injection in order to avoid nerve injury. Ten adult and 10 child cadavers were used. The superior and inferior gluteal nerves innervating the gluteus maximus, medius, and minimus were dissected, exposed, and sutured in-situ on the muscle. The three gluteal muscles were removed, and the distribution patterns of the intramuscular nerves were revealed by modified Sihler’s nerve staining. The nerve distribution pattern was returned to the corresponding position in the body, and the patterns in the four quadrants of the buttock were analyzed. There were 3–12 extramuscular nerve branches of the gluteus maximus, medius, and minimus. After entering the muscle, these nerve branches arborized and anastomosed to form an arc-shaped, nerve-dense zone. The nerve distribution was most dense in the inferomedial region of the superolateral quadrant and the inferolateral region of the superomedial quadrant of the buttocks. The nerve distribution was relatively dense in the inferolateral region of the superolateral quadrant, and the medial region of the inferomedial quadrant. An arc-shaped, nerve-sparse zone in the superolateral and superomedial quadrants near the lower iliac crest accounted for about two-fifths of the two quadrants’ limits. The arc-shaped, nerve-sparse zone in the superolateral quadrant is the preferred injection site, and the superomedial quadrant near the lower iliac crest is also recommended as a gluteal intramuscular injection region, free from nerve injury.

KEY WORDS: Gluteal muscle injection; Sihler's staining; Nerve distribution pattern; Injection nerve injury; Intramuscular injection site.

How to cite this article

WU, J.; CAI, Y.; CAO, A.; BI, Y.; HU, X. & YANG, S. Recommendation of the best site based on the distribution pattern of extramuscular and intramuscular nerves for gluteal muscle injection. Int. J. Morphol., 38(4):975-982, 2020.