Charmode Sundip, Mehra Simmi, Mishra Abhishek Kumar
Anatomy, All India Institute of Medical Sciences Rajkot, Rajkot, IND.
Orthopedics and Traumatology, All India Institute of Medical Sciences Rajkot, Rajkot, IND.
Cureus. 2024 Aug 7;16(8):e66391. doi: 10.7759/cureus.66391. eCollection 2024 Aug.
Background and aim The deltoid is a common site for intramuscular injections, but guidelines for administration lack standardization. Global researchers propose various techniques, and recent study reports indicate a 1.5-15% incidence of nerve palsies due to injections. This pilot cadaveric study aimed to standardize the deltoid intramuscular injection sites in the Southeast Asian population. Methods This cadaveric study of a two-year duration was conducted in the Department of Anatomy as an intramural research project in collaboration with the Departments of Anatomy and Orthopedics. In the first year of study, which was the pilot phase of the project, the available six cadavers, i.e., 12 upper extremity specimens were dissected. Anthropometric measurements of deltoid muscle along with the distance of underlying neurovascular structures like the axillary nerve and posterior circumflex humeral artery were measured from neighboring bony landmarks. This article presents the observations of the six cadavers studied in the pilot phase and shall be followed up by another article after the project. Results In adults, in anatomical position, the mean distances of the axillary nerve and posterior circumflex humeral artery from the mid-acromial point are 8.19±0.616 and 8.66±0.968 cm, respectively. The deltoid thickness at 3, 5, and 7 cm from mid-acromial point was observed to be 1.079±0.13 cm (0.5-1.78 cm), 1.599±0.12 cm (1-2.96 cm), and 1.815±1.0 cm (1.2-2.5 cm), respectively. The acquired qualitative and quantitative data were tabulated, graphically represented, and statistically analyzed. Conclusions The deltoid intramuscular injection (IMI) must be given at or below the level of the midpoint of the deltoid muscle, but never in the upper half. We recommend a site, 4 fingerbreadths/9 cm below the mid-acromion point as the safest site to avoid injury to any underlying neurovascular structures.
背景与目的 三角肌是肌内注射的常见部位，但注射指南缺乏标准化。全球研究人员提出了各种技术，最近的研究报告显示，注射导致神经麻痹的发生率为1.5%至15%。这项尸体研究旨在规范东南亚人群三角肌肌内注射部位。方法 这项为期两年的尸体研究作为一项校内研究项目，在解剖学系与解剖学系和骨科合作开展。在研究的第一年，即项目的试点阶段，解剖了现有的6具尸体，即12个上肢标本。从相邻的骨性标志测量三角肌的人体测量学数据以及腋神经和旋肱后动脉等深层神经血管结构的距离。本文介绍了试点阶段研究的6具尸体的观察结果，项目完成后将有另一篇文章跟进。结果 在成人中，在解剖位置，腋神经和旋肱后动脉距肩峰中点的平均距离分别为8.19±0.616厘米和8.66±0.968厘米。在距肩峰中点3、5和7厘米处，三角肌厚度分别为1.079±0.13厘米（0.5至1.78厘米）、1.599±0.12厘米（1至2.96厘米）和1.815±1.0厘米（1.2至2.5厘米）。对获取的定性和定量数据进行了列表、图形表示和统计分析。结论 三角肌肌内注射必须在三角肌中点或以下进行，但绝不能在上半部分。我们建议在肩峰中点下方4指宽/9厘米处作为最安全的注射部位，以避免损伤任何深层神经血管结构。
