title: Approach for needle insertion into the tibialis posterior: An ultrasonography study.
abstract: BACKGROUND
  To avoid neurovascular damage by needle electrode insertion into the tibialis posterior, we used ultrasonography to determine the proper insertion point based on anatomic landmarks.
  
  
  METHODS
  Using ultrasonography, the safety window, the corrected safety window, and the depth of the tibialis posterior were measured at 4 points (the upper third and midpoint of the tibia using anterior and posterior approaches) in healthy volunteers.
  
  
  RESULTS
  The safety window at the midpoint for the posterior approach was significantly larger than at the other points. The corrected safety window could be defined only at the upper third for the anterior approach and at the midpoint for the posterior approach.
  
  
  CONCLUSIONS
  Among the 4 points used for needle insertion into the tibialis posterior, the midpoint by the posterior approach may be the most favorable insertion point. The upper third may be better for the anterior approach.
authors.affiliation: Department of Rehabilitation Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Sun Jae
authors.initials: SJ
authors.lastname: Won
authors.affiliation: Department of Rehabilitation Medicine, Guro Hospital, Korea University College of Medicine, 80 Guro Gu, Guro dong, Seoul, South Korea.
authors.forename: Joon Shik
authors.initials: JS
authors.lastname: Yoon
mesh_terms: D000328:Adult; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D007866:Leg / Q000000981:diagnostic imaging* / Q000294:innervation; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging* / Q000294:innervation; D013710:Tendons / Q000000981:diagnostic imaging / Q000294:innervation; D013977:Tibia / Q000000981:diagnostic imaging* / Q000294:innervation; D018084:Ultrasonography, Interventional / Q000295:instrumentation* / Q000379:methods
keywords: anterior approach; electromyography; posterior approach; tibialis posterior; ultrasonography