title: Ultrasonographic evaluation of needle electromyography insertion into the tibialis posterior using a posterior approach.
abstract: OBJECTIVE
  To estimate the safety window for needle insertion in the posterior approach to the tibialis posterior by ultrasonography, particularly in a clinical setting.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Healthy volunteers (108 legs, from 22 men and 32 women).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  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.affiliation: Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Sun Jae
authors.initials: SJ
authors.lastname: Won
authors.forename: Jun Yeon
authors.initials: JY
authors.lastname: Kim
authors.forename: Joon Shik
authors.initials: JS
authors.lastname: Yoon
authors.forename: Sei Joo
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D001837:Body Weights and Measures; D003430:Cross-Sectional Studies; D004576:Electromyography / Q000379:methods*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D013977:Tibia / Q000000981:diagnostic imaging*; D014463:Ultrasonography