OBJECTIVE: To estimate the safety window for needle insertion in the posterior approach to the tibialis posterior by ultrasonography, particularly in a clinical setting. DESIGN: Cross-sectional study. SETTING: University hospital. PARTICIPANTS: Healthy volunteers (108 legs, from 22 men and 32 women). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Distance between the tibia and neurovascular bundles in the posterior aspect of the tibia on a transverse ultrasonographic scan. RESULTS: The safety window at the midpoint was significantly larger than the upper third (0.62-2.16 cm, average 1.47 ± 0.38 cm vs 0.51-1.62 cm, average 1.16 ± 0.31 cm). The depth at the midpoint was significantly more shallow than the upper third (1.57-3.16 cm, average 2.31 ± 0.34 cm vs 1.76-3.66 cm, average 2.52 ± 0.38 cm). Body weight, height, tibial length, and leg circumference showed positive correlation with the safety window at both points. CONCLUSIONS: The midpoint may be more favorable than the upper third for needle insertion to the tibialis posterior with a posterior approach.
OBJECTIVE: To estimate the safety window for needle insertion in the posterior approach to the tibialis posterior by ultrasonography, particularly in a clinical setting. DESIGN: Cross-sectional study. SETTING: University hospital. PARTICIPANTS: Healthy volunteers (108 legs, from 22 men and 32 women). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Distance between the tibia and neurovascular bundles in the posterior aspect of the tibia on a transverse ultrasonographic scan. RESULTS: The safety window at the midpoint was significantly larger than the upper third (0.62-2.16 cm, average 1.47 ± 0.38 cm vs 0.51-1.62 cm, average 1.16 ± 0.31 cm). The depth at the midpoint was significantly more shallow than the upper third (1.57-3.16 cm, average 2.31 ± 0.34 cm vs 1.76-3.66 cm, average 2.52 ± 0.38 cm). Body weight, height, tibial length, and leg circumference showed positive correlation with the safety window at both points. CONCLUSIONS: The midpoint may be more favorable than the upper third for needle insertion to the tibialis posterior with a posterior approach.
Authors: Albert Pérez-Bellmunt; Carlos López-de-Celis; Jacobo Rodríguez-Sanz; Shane L Koppenhaver; Daniel Zegarra-Chávez; Sara Ortiz-Miguel; César Fernández-de-Las-Peñas Journal: BMC Musculoskelet Disord Date: 2022-06-14 Impact factor: 2.562