Department of Physical Medicine and Rehabilitation, College of Medicine, Korea University, Ansan, Republic of Korea.
Department of Anatomy, Korea University College of Medicine, Seoul, Republic of Korea.
Muscle Nerve. 2022 Jul;66(1):80-84. doi: 10.1002/mus.27545. Epub 2022 Apr 25.
INTRODUCTION/AIMS: The existing methods for needle electromyography are confusing as to which is the safest and most effective. Our aim was to identify the optimal and safest needle electromyographic insertion site in the supinator muscle.
We performed a two-step cadaveric dissection of the supinator muscle and related neurovascular structures. The study was performed using 18 upper limbs of 9 fresh adult cadavers (step 1) and 14 upper limbs of 7 fresh adult cadavers (step 2). In step 1, an imaginary line connecting the radial head (RH) and midpoint of the dorsal wrist (RW line) was drawn, and the distance from the RH to the point where the RW line and posterior interosseous nerve (PIN) intersect (L_CROSS) was measured on the RW line. In step 2, the needle was inserted 30 mm distal to the RH according to the results of step 1. After injection with India ink, dissection was performed to measure the distance between the needle insertion site and PIN (L_CROSS_Inj) on the RW line.
The median L_CROSS was 51.4 (35.5-65.6) mm. Needle insertion spared the PIN in all cases during step 2, and the needle was inserted into the supinator muscle in all cases. The median L_CROSS_Inj was 27.4 (13.2-39.8) mm.
A safe and accurate needle insertion site for the supinator muscle is approximately 30 to 40 mm distal to the RH along the RW line.
介绍/目的：现有的肌电图针插入方法对于哪种方法最安全和最有效存在混淆。我们的目的是确定旋后肌中最佳和最安全的肌电图针插入部位。
我们对旋后肌和相关的神经血管结构进行了两步尸体解剖。该研究使用了 9 具新鲜成人尸体的 18 个上肢（第 1 步）和 7 具新鲜成人尸体的 14 个上肢（第 2 步）进行。在第 1 步中，绘制了一条连接桡骨头（RH）和腕背中点（RW 线）的假想线，并在 RW 线上测量了从 RH 到 RW 线和骨间后神经（PIN）交点的点（L_CROSS）的距离。在第 2 步中，根据第 1 步的结果，在 RH 远端插入 30 mm 的针。注入印度墨水后，在 RW 线上进行解剖，以测量针插入部位和 PIN 之间的距离（L_CROSS_Inj）。
中位 L_CROSS 为 51.4（35.5-65.6）mm。在第 2 步中，所有情况下针插入都避开了 PIN，并且所有情况下针都插入了旋后肌。中位 L_CROSS_Inj 为 27.4（13.2-39.8）mm。
沿 RW 线，RH 远端约 30 至 40 mm 处是旋后肌安全准确的针插入部位。
