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Article

The Precision and Safety of Ultrasound-Guided versus Palpation-Guided Needle Placement on the Plantar Fascia and Flexor Digitorum Brevis Interface: An Anatomical Study

by
Miguel Malo-Urriés
1,†,
Sergio Borrella-Andrés
1,†,
Carlos López-de-Celis
2,3,4,
César Fernández-de-las-Peñas
5,*,
Albert Pérez-Bellmunt
2,3,
José L. Arias-Buría
5,
Isabel Albarova-Corral
1 and
Jacobo Rodríguez-Sanz
2,3
1
Health Sciences Faculty, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
2
Faculty of Medicine and Health Sciences, Universitat International de Catalunya, 08195 Sant Cugat del Vallès, Spain
3
ACTIUM Functional Anatomy Group, 08195 Sant Cugat del Vallès, Spain
4
Fundació Institut, Universitari per a La Recerca a l’Atenció, Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08028 Barcelona, Spain
5
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this manuscript.
Healthcare 2024, 12(10), 1000; https://doi.org/10.3390/healthcare12101000
Submission received: 18 April 2024 / Revised: 8 May 2024 / Accepted: 11 May 2024 / Published: 13 May 2024
(This article belongs to the Special Issue New Approaches in Invasive and Non-Invasive Rehabilitation: From Basic Science to Clinical Intervention)
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Abstract

Background: Evidence suggests the plantar fascia and its interphase with the flexor digitorum brevis muscle can play a relevant role in plantar heel pain. Needling interventions could offer an appropriate treatment strategy to addressing this interface. Objective: We compared the accuracy and safety of ultrasound-guided versus palpation-guided procedures for the proper targeting of the interface between the plantar fascia and the flexor digitorum brevis with a solid needle. Methods: A crossover cadaveric study was conducted. Five experienced therapists performed a series of 20 needle insertions each (n = 100 in total, 10 landmark-guided and 10 ultrasound-guided) on 10 anatomical samples. The therapists were instructed to accurately place the needle on the interface between the plantar fascia and the flexor digitorum brevis muscle. The distance of the tip of the needle to the identified target (accuracy), the surrounding sensitive structures targeted (safety), the time needed for the procedure, the number of needle passes, and the needle length outside the skin were assessed. Results: The ultrasound-guided technique was associated with a significantly higher accuracy (p < 0.001) but without differences in safety (p = 0.249) as compared to the palpation-guided procedure. Conclusion: Our results suggest that ultrasound-guided insertion exhibits greater accuracy but not greater safety than palpation-guided insertion when targeting the interface between the plantar fascia and the flexor digitorum brevis.
Keywords: plantar fascia; ultrasound; needling; interphase; accuracy; safety; cadaver plantar fascia; ultrasound; needling; interphase; accuracy; safety; cadaver

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MDPI and ACS Style

Malo-Urriés, M.; Borrella-Andrés, S.; López-de-Celis, C.; Fernández-de-las-Peñas, C.; Pérez-Bellmunt, A.; Arias-Buría, J.L.; Albarova-Corral, I.; Rodríguez-Sanz, J. The Precision and Safety of Ultrasound-Guided versus Palpation-Guided Needle Placement on the Plantar Fascia and Flexor Digitorum Brevis Interface: An Anatomical Study. Healthcare 2024, 12, 1000. https://doi.org/10.3390/healthcare12101000

AMA Style

Malo-Urriés M, Borrella-Andrés S, López-de-Celis C, Fernández-de-las-Peñas C, Pérez-Bellmunt A, Arias-Buría JL, Albarova-Corral I, Rodríguez-Sanz J. The Precision and Safety of Ultrasound-Guided versus Palpation-Guided Needle Placement on the Plantar Fascia and Flexor Digitorum Brevis Interface: An Anatomical Study. Healthcare. 2024; 12(10):1000. https://doi.org/10.3390/healthcare12101000

Chicago/Turabian Style

Malo-Urriés, Miguel, Sergio Borrella-Andrés, Carlos López-de-Celis, César Fernández-de-las-Peñas, Albert Pérez-Bellmunt, José L. Arias-Buría, Isabel Albarova-Corral, and Jacobo Rodríguez-Sanz. 2024. "The Precision and Safety of Ultrasound-Guided versus Palpation-Guided Needle Placement on the Plantar Fascia and Flexor Digitorum Brevis Interface: An Anatomical Study" Healthcare 12, no. 10: 1000. https://doi.org/10.3390/healthcare12101000

APA Style

Malo-Urriés, M., Borrella-Andrés, S., López-de-Celis, C., Fernández-de-las-Peñas, C., Pérez-Bellmunt, A., Arias-Buría, J. L., Albarova-Corral, I., & Rodríguez-Sanz, J. (2024). The Precision and Safety of Ultrasound-Guided versus Palpation-Guided Needle Placement on the Plantar Fascia and Flexor Digitorum Brevis Interface: An Anatomical Study. Healthcare, 12(10), 1000. https://doi.org/10.3390/healthcare12101000

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