Lee Seung Min, Kim Kihoon, Lee Sang Min, Lee Hyun Seok
Department of Rehabilitation Medicine, VHS Medical Center, Seoul, Korea.
Ann Rehabil Med. 2013 Apr;37(2):215-20. doi: 10.5535/arm.2013.37.2.215. Epub 2013 Apr 30.
To establish the safest approach to needle electrode insertion into the flexor pollicis longus (FPL) regarding possible needle injury to the superficial radial nerve (SRN) or radial artery by ultrasonography.
We evaluated 54 forearms of 27 healthy subjects. Three levels were defined in the forearm. Level 1 is the junction of the middle and distal third of the forearm, level 3 is the midpoint of forearm length, and level 2 is the midpoint between two levels. At each level, the distance between the most prominent point of the radius and the SRN (region A), the distance between the SRN and the radial artery (region B), and the depth from the skin surface to the FPL were measured.
The distance of region A was 1.20±0.41 cm in level 1, 1.62±0.45 cm in level 2, and 1.95±0.49 cm in level 3. The distance of region B was 1.02±0.29 cm in level 1, 0.61±0.24 cm in level 2, and 0.37±0.19 cm in level 3. The depth from the skin surface to the FPL was 0.92±0.20 cm in level 1, 1.14±0.26 cm in level 2, and 1.45±0.29 cm in level 3.
The safest needle insertion point to the FPL is the middle of the forearm within approximately 0.8 cm from the most prominent point of the radius. We recommend that the needle is inserted at the above point perpendicular to the skin surface until the needle meets the FPL at a depth of approximately 1.45 cm from the skin surface.
通过超声检查确定将针电极插入拇长屈肌（FPL）时，针对可能损伤桡浅神经（SRN）或桡动脉的最安全进针方法。
我们评估了27名健康受试者的54条前臂。在前臂定义了三个水平。水平1为前臂中、下三分之一交界处，水平3为前臂长度中点，水平2为两者中点。在每个水平，测量桡骨最突出点与SRN之间的距离（A区）、SRN与桡动脉之间的距离（B区）以及从皮肤表面到FPL的深度。
A区距离在水平1为1.20±0.41厘米，水平2为1.62±0.45厘米，水平3为1.95±0.49厘米。B区距离在水平1为1.02±0.29厘米，水平2为0.61±0.24厘米，水平3为0.37±0.19厘米。从皮肤表面到FPL的深度在水平1为0.92±0.20厘米，水平2为1.14±0.26厘米，水平3为1.45±0.29厘米。
FPL最安全的进针点是在前臂中部，距桡骨最突出点约0.8厘米范围内。我们建议在上述点垂直于皮肤表面进针，直到针在距皮肤表面约1.45厘米深处触及FPL。
