A Study on Finding a Correct and Simple Identifing Method of the Intramuscular Injection Sites in the Buttocks

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The author investigated the reliability of the safe area, which previously was defined to prevent injury to the superior gluteal nerve during the lateral approach to the hip. It is suggested that delivering an injection to Jacobs' safe area is associated with a high risk of injury to the superior gluteal nerve, artery, and vein on the basis of the dense distribution of this nerve branch and the inadequate thickness to the bottom of the gluteus medius muscle. Thus, Jacobs' safe area appears not to be suited for intramuscular injection. On the other hand, Clark's point is suggested as a safe injection site because of the low risk of injury to nerves and vessels : the depth to the bottom of the gluteus medius muscle is adequate to prevent the needle inserted from becoming close to the superior gluteal nerve along the bottom of the gluteus medius muscle. When the posterior superior iliac spine is difficult to find, the site 7-8 cm from the anterior superior iliac spine on the line linking the right and left anterior superior iliac spines will be a safe site for intramuscular injection.