TY - JOUR
T1 - Optimal needle placement for extensor hallucis longus muscle
T2 - A cadaveric study
AU - Cheong, In Yae
AU - Kim, Do Kyun
AU - Oh, Ye Jeong
AU - Park, Byung Kyu
AU - Kim, Ki Hoon
AU - Kim, Dong Hwee
N1 - Publisher Copyright:
© 2016 by Korean Academy of Rehabilitation Medicine.
Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.
PY - 2016
Y1 - 2016
N2 - Objective To determine the midpoint (MD) of extensor hallucis longus muscle (EHL) and compare the accuracy of different needle electromyography (EMG) insertion techniques through cadaver dissection. Methods Thirty-eight limbs of 19 cadavers were dissected. The MD of EHL was marked at the middle of the musculotendinous junction and proximal origin of EHL. Three different needle insertion points of EHL were marked following three different textbooks: M1, 3 fingerbreadths above bimalleolar line (BML); M2, junction between the middle and lower third of tibia; M3, 15 cm proximal to the lower border of both malleoli. The distance from BML to MD (BML_MD), and the difference between 3 different points (M1-3) and MD were measured (designated D1, D2, and D3, respectively). The lower leg length (LL) was measured from BML to top of medial condyle of tibia. Results The median value of LL was 34.5 cm and BML_MD was 12.0 cm. The percentage of BML_MD to LL was 35.1%. D1, D2, and D3 were 7.0, 0.9, and 3.0 cm, respectively. D2 was the shortest, meaning needle placement following technique by Lee and DeLisa was closest to the actual midpoint of EHL. Conclusion The MD of EHL is approximately 12 cm above BML, and about distal 35% of lower leg length. Technique that recommends placing the needle at distal two-thirds of the lower leg (M2) is the most accurate method since the point was closest to muscle belly of EHL.
AB - Objective To determine the midpoint (MD) of extensor hallucis longus muscle (EHL) and compare the accuracy of different needle electromyography (EMG) insertion techniques through cadaver dissection. Methods Thirty-eight limbs of 19 cadavers were dissected. The MD of EHL was marked at the middle of the musculotendinous junction and proximal origin of EHL. Three different needle insertion points of EHL were marked following three different textbooks: M1, 3 fingerbreadths above bimalleolar line (BML); M2, junction between the middle and lower third of tibia; M3, 15 cm proximal to the lower border of both malleoli. The distance from BML to MD (BML_MD), and the difference between 3 different points (M1-3) and MD were measured (designated D1, D2, and D3, respectively). The lower leg length (LL) was measured from BML to top of medial condyle of tibia. Results The median value of LL was 34.5 cm and BML_MD was 12.0 cm. The percentage of BML_MD to LL was 35.1%. D1, D2, and D3 were 7.0, 0.9, and 3.0 cm, respectively. D2 was the shortest, meaning needle placement following technique by Lee and DeLisa was closest to the actual midpoint of EHL. Conclusion The MD of EHL is approximately 12 cm above BML, and about distal 35% of lower leg length. Technique that recommends placing the needle at distal two-thirds of the lower leg (M2) is the most accurate method since the point was closest to muscle belly of EHL.
KW - Cadaver
KW - Electromyography
KW - Extensor hallucis longus muscle
KW - Needles
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U2 - 10.5535/arm.2016.40.3.457
DO - 10.5535/arm.2016.40.3.457
M3 - Article
AN - SCOPUS:84981272269
VL - 40
SP - 457
EP - 462
JO - Annals of Rehabilitation Medicine
JF - Annals of Rehabilitation Medicine
SN - 2234-0645
IS - 3
ER -