Needle Electrode Insertion Into the Tibialis Posterior: A Comparison of the Anterior and Posterior Approaches

Yang S-N, Lee S-H, Kwon H-K. Needle electrode insertion into the tibialis posterior: a comparison of the anterior and posterior approaches. Objectives: To analyze and compare the safety of the anterior and posterior approaches for needle electrode placement and to examine the method for inserting the needle electrode using the anterior approach. Design: Cross-sectional study. Setting: University hospital. Participants: Lower-extremity radiographs and magnetic resonance images of 22 patients (13 men, 9 women). Interventions: Not applicable. Main Outcome Measure: Measurement of lower-extremity radiographs and magnetic resonance imaging. Results: The anterior approach offers the advantage of a larger safe window for needle insertion into the upper third of the leg than the posterior approach. No significant differences were observed between the anterior and posterior approaches in terms of safety of needle insertion into the midpoint. The safe zone of the overlying skin for needle insertion was found to be approximately 40% to 80% of the width of the tibia away from the lateral margin of the tibia shaft on the upper third of the leg and 32% to 58% of the width of the tibia at the midpoint of the leg in the anterior approach. Conclusions: The method suggested in this article can be used for needle electromyography and deserves more widespread use in clinical practice.