Safe zones for external fixation in the tibia: A cadaveric study

Gyong-Ryol Kang; Jin-Myong Ra; Mun-Sik Ko; Yong-Chol Pak; Dong-Won Mun; Gwang-Rim Choe; Tae-Pom Choe

Abstract

AbstractPurpose: The aim of this study was to determine the relationship between the neurovascular structures and the tibia, by measuring the distances from the tibia to the surrounding neurovascular structures and angles at which the neurovascular structures course around the tibia. Materials and Methods: Ten fresh adult cadavers(5 men, 5 women), which had been donated to the Human anatomy department, were obtained within 72h of death, providing 20 lower extremity specimens without deformity or previous surgery. The lower legs were divided into 8 segments equally from the proximal end to the distal end, and dissected circumferentially to measure the distances from the tibia to the surrounding neurovascular structures and angles at which the neurovascular structures course around the tibia. Results: The neurovascular structures that lie near to the tibia are saphenous and common peroneal nerves at segment 1; saphenous nerve at segments 2, 5, 6 and 7; anterior tibial vein at segment 5; great saphenous vein, peroneal artery and vein, anterior tibial artery and vein, and deep peroneal nerve at segment 6; great saphenous vein, peroneal artery and vein, superficial peroneal nerve, anterior tibial artery and vein, and deep peroneal nerve at segment 7; great saphenous vein, posterior tibial vein, peroneal artery and vein, superficial and deep peroneal nerves, anterior tibial artery and vein at segment 8. These neurovascular structures are within 5-6mm from the tibia at various angels. Conclusions: Knowledge of the neurovascular structures that course near to the tibia is essential for orthopedists to avoid iatrogenic neurovascular injury during external fixation of the tibia. Keywords: Cadaveric, External fixation, Neurovascular structure, Safe zone, TibiaCite this ArticleGyong-Ryol Kang, Jin-Myong Ra, Mun-Sik Ko, Yong-Chol Pak, Dong-Won Mun, Gwang-Rim Choe. Safe Zones for External Fixation in the Tibia: A Cadaveric Study. Research & Reviews: Journal of Surgery. 2020; 9(1): 16–20p.