사체를 이용한 원회내근의 침 근전도 방법 간의 유용성 비교

Abstract

Objective: To compare electromyography needle insertion sites to the pronator teres and identify the safe needle location to minimize neurovascular injury. Methods: Twenty-nine upper limbs of 19 adult cadavers were dissected. The total length of pronator teres (PT) and the angle between elbow crease and the lateral border of pronator teres were measured. Needle insertion sites were at 2.5 cm distally from the cross-point of elbow crease and pronator teres (M1), at two finger breadths distal to the midpoint of a line connecting the medial epicondyle and biceps tendon (M2), and 5cm distal to the midpoint of elbow crease (M3). Distances from the humeral origin of the pronator teres to M1, M2, and M3, and distances from the humeral origin of the pronator teres to brachial artery and median nerve were measured. Results: The mean length of the PT was 9.2±1.8 cm and the angle between elbow crease and the lateral border of pronator teres was 63.5±7.7 degrees. The distances from the origin of pronator teres to M1,M2, M3, brachial artery, and median nerve were 3.2±0.7 cm, 3.6±0.5 cm, 5.9±0.7 cm, 4.4±0.6 cm, and 3.6±0.6 cm, respectively. Conclusion: Among the three needle insertion sites, M1 seems to be a safe method to evaluate pronator teres with needle. However, the tip of needle must be directed towards the origin of the pronator teres to avoid incidental injury of neurovascular bundle.