Cadaveric study of methods for subscapularis muscle needle insertion.
OBJECTIVE
To evaluate the accuracy for three methods for needle insertion into the subscapularis muscle for electromyography, botulinum toxin injection, and phenol nerve block.


METHODS
Three needle insertion methods were evaluated by cadaver injection by an American Board of Electrodiagnostic Medicine certified physician. An anatomist, blinded to the method used, served as the dissector to evaluate the effectiveness of the methods tested.


RESULTS
A posterior axillary approach was most effective for needle insertion into the subscapular muscle compared with a medial scapular or a superior scapular approach. No approach was ideal for subscapular nerve injection.


CONCLUSIONS
A posterior axillary approach is best for needle insertion of the subscapularis muscle for electromyography or botulinum toxin injection. Subscapular nerve injection is difficult from all of the three approaches tested.
Chiodo
Anthony
A
Department of Physical Medicine and Rehabilitation, University of Michigan Hospital, Ann Arbor 48108, USA.
Goodmurphy
Craig
C
Haig
Andrew
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage; D002102:Cadaver; D004576:Electromyography / Q000379:methods*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009339:Needles; D009407:Nerve Block / Q000379:methods*; D009465:Neuromuscular Agents / Q000008:administration & dosage; D017006:Rotator Cuff
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A