Dorsal dry needling to the pronator quadratus muscle is a safe and valid technique: a cadaveric study

Background: The pronator quadratus (PQ) muscle is an important stabilizer of the distal radio-ulnar joint and its pain referral pattern can mimic median or ulnar neuropathy. Research on treatment safety and efficacy with dry needling is scarce. Objective: To determine if a solid filiform needle accu...

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Bibliographic Details
Authors: Pérez Bellmunt, Albert, López de Celis, Carlos, Rodríguez Sanz, Jacobo, Hidalgo García, César, Donnelly, Joseph M., Cedeño Bermúdez, Simón A., Fernández de las Peñas, César
Format: article
Publication Date:2023
Country:España
Institution:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repository:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:20.500.12328/4946
Online Access:http://hdl.handle.net/20.500.12328/4946
https://dx.doi.org/10.1080/09593985.2022.2031365
Access Level:Open access
Keyword:Pronador quadrat
Punció seca
Cadàver
Seguretat
Nervi
Artèria
Pronador cuadrado
Punción seca
Seguridad
Cadáver
Nervio
Arteria
Pronator quadratus
Dry needling
Cadaver
Safety
Nerve
Artery
616.7
Description
Summary:Background: The pronator quadratus (PQ) muscle is an important stabilizer of the distal radio-ulnar joint and its pain referral pattern can mimic median or ulnar neuropathy. Research on treatment safety and efficacy with dry needling is scarce. Objective: To determine if a solid filiform needle accurately and safely penetrates the PQ during simulated clinical application of dry needling. Methods: A cadaveric descriptive study was conducted. Needling insertion of PQ was performed in 10 cryopreserved forearms with a 30*0.32 mm solid filiform needle. With the forearm pronated, the needle was inserted 3 cm proximal to the ulnar styloid in an anterior direction toward the muscle. The needle was advanced into the PQ based upon clinician judgment. Safety was assessed by calculating the distance from the needle to the surrounding neurovascular bundles. Results: Accurate needle penetration of the PQ was observed in 90% of the cadavers (needle penetration: 19.8 ± 4.0 mm, 95%CI 17.0 to 22.6 mm). No neurovascular bundle was pierced during needling in any specimen forearms. The distance from the tip of the needle was 15.1 ± 4.8 mm (95%CI 11.7 to 18.5 mm) to the ulnar nerve, 15.6 ± 7.6 mm (95%CI 10.0 to 21 mm) to the ulnar artery, 11.2 ± 3.3 mm (95%CI 8.8 to 13.6 mm) to the median nerve, and 4.9 ± 1.4 mm (95%CI 3.9 to 5.9 mm) to the anterior interosseous neurovascular bundle. Conclusion: The results from this cadaveric study support the assumption that needling of the PQ by the dorsal aspect of the forearm can be accurately and safely conducted by an experienced clinician. Studies investigating the clinical safety and effectiveness of this interventions are needed.