Safe Needle Insertion Locations for Motor Point Injection of the Triceps Brachii Muscle: A Pilot Cadaveric and Ultrasonography Study
10.5535/arm.2019.43.6.635
- Author:
Hyun Jung KOO
1
;
Hye Jung PARK
;
Geun Young PARK
;
Yeonjae HAN
;
Donggyun SOHN
;
Sun IM
Author Information
1. Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Cadaver;
Ultrasonography;
Muscle spasticity;
Botulinum toxins
- MeSH:
Acromion;
Botulinum Toxins;
Cadaver;
Elbow;
Head;
Healthy Volunteers;
Humerus;
Korea;
Motor Endplate;
Muscle Spasticity;
Muscles;
Needles;
Olecranon Process;
Schools, Medical;
Seoul;
Skin;
Ultrasonography;
Upper Extremity
- From:Annals of Rehabilitation Medicine
2019;43(6):635-641
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To determine the location of the motor endplate zones (MoEPs) for the three heads of the triceps brachii muscles during cadaveric dissection and estimate the safe injection zone using ultrasonography.METHODS: We studied 12 upper limbs of 6 fresh cadavers obtained from body donations to the medical school anatomy institution in Seoul, Korea. The locations of MoEPs were expressed as the percentage ratio of the vertical distance from the posterior acromion angle to the midpoint of the olecranon process. By using the same reference line as that used for cadaveric dissection, the safe injection zone away from the neurovascular bundle was identified in 6 healthy volunteers via ultrasonography. We identified the neurovascular bundle and its location with respect to the distal end of the humerus and measured its depth from the skin surface.RESULTS: The MoEPs for the long, lateral, and medial heads were located at a median of 43.8%, 54.8%, and 60.4% of the length of the reference line in cadaver dissection. The safe injection zone of the medial head MoEPs corresponded to a depth of approximately 3.5 cm from the skin surface and 1.4 cm away from the humerus, as determined by sonography.CONCLUSION: Correct identification of the motor points for each head of the triceps brachii would increase the precision and efficacy of motor point injections to manage elbow extensor spasticity.
