In our previous study, we identified a novel intramuscular injection point located at the intersection of the horizontal line from the anterior superior iliac spine and the perpendicular line from the middle portion of the trochanter major with the extended hip joint, and clarified that this site is as safe as the point of Clark for intramuscular injection. The aims of the present study were to determine whether intramuscular injection at our novel point is safe during flexion of the hip joint, and to determine the optimal depth of needle insertion for use in clinical settings. We determined four sites as injection points in the right buttocks of women aged 21-27 at four sites: Clark's point, our novel intramuscular point with extended hip joint (angle 0°), our novel point with hip joint flexed 45° and our novel point with hip joint flexed 90°. After measuring the distances between the point of Clark and each novel intramuscular injection point, we used ultrasound to measure the thickness of subcutaneous fat and gluteal muscle, and measured blood flow. We found that our novel intramuscular injection point was near the point of Clark during hip joint flexion, and the thickness of the subcutaneous fat and the gluteal muscle did not show significant differences. Our results suggested that this novel point is safe for intramuscular injection. We furthermore examined the optimal depth for insertion of the needle, considering the thickness of the subcutaneous fat, and found that inserting the needle 3 cm perpendicular to the skin is ideal for safe intramuscular injection, because it helps prevent damage to the nerves and blood vessels.
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