Accuracy of Manual Needle Placement for Gastrocnemius Muscle in Children With Cerebral Palsy Checked Against Ultrasonography
Abstract
Yang EJ, Rha D, Yoo JK, Park ES. Accuracy of manual needle placement for gastrocnemius muscle in children with cerebral palsy checked against ultrasonography.
Objective
To investigate the accuracy of manual needle placement into gastrocnemius muscle (GCM) for botulinum toxin type A (BTX-A) injection in children with spastic cerebral palsy (CP).
Design
Prospective clinical study.
Setting
University-affiliated hospital.
Participants
A total of 272 injections in GCMs of 39 children with spastic CP who were scheduled to receive BTX-A injections in GCMs.
Intervention
Not applicable.
Main Outcome Measures
The accuracy of manual needle placement was checked against ultrasonography.
Results
The needle was accurately inserted into GCM muscles in 78.7% of cases. Accuracy was 92.6% into gastrocnemius medialis (GM) and 64.7% into gastrocnemuis lateralis (GL). Muscle thickness at the needle insertion site was significantly thinner in GL than GM. Accuracy of GL in the younger age group (<4y, 57.6%) was lower than in the older age group (≥4y, 78.1%). For GM, accuracy in both younger and older age groups was good (>90%).
Conclusions
Injection of the toxin into GCMs through the use of anatomic landmark was acceptable in GM, but not acceptable in GL, especially in young children.
Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
Correspondence to Eun Sook Park, MD, PhD, Rehabilitation Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, Korea, 120-752
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT