OBJECTIVES: To locate the proper insertion point for a tibial intramedullary nail in the coronal plane. DESIGN: Fifty-seven cadaveric lower legs were disarticulated at the knee and ankle and stripped of their soft tissue. Each tibia was nailed in a retrograde fashion through the center of the tibial plafond with a seven-millimeter sharp-tipped rod through the proximal tibia. The exit point of the nail was measured in the coronal plane in relation to the tibial tubercle. RESULTS: Except for one tibia, the intramedullary nail exit point was always located medial to the center of the tibial tubercle with the average being eight millimeters +/- six millimeters medial to the center of the tibial tubercle. Forty-six percent of the nails exited medial to the whole tibial tubercle. CONCLUSIONS: The insertion point of a tibial nail should be over the medial aspect of the tibial tubercle in the coronal plane. Our data supports using a medial or patellar splitting approach for nail insertion. Insertion sites lateral to the tibial tubercle should be avoided.
OBJECTIVES: To locate the proper insertion point for a tibial intramedullary nail in the coronal plane. DESIGN: Fifty-seven cadaveric lower legs were disarticulated at the knee and ankle and stripped of their soft tissue. Each tibia was nailed in a retrograde fashion through the center of the tibial plafond with a seven-millimeter sharp-tipped rod through the proximal tibia. The exit point of the nail was measured in the coronal plane in relation to the tibial tubercle. RESULTS: Except for one tibia, the intramedullary nail exit point was always located medial to the center of the tibial tubercle with the average being eight millimeters +/- six millimeters medial to the center of the tibial tubercle. Forty-six percent of the nails exited medial to the whole tibial tubercle. CONCLUSIONS: The insertion point of a tibial nail should be over the medial aspect of the tibial tubercle in the coronal plane. Our data supports using a medial or patellar splitting approach for nail insertion. Insertion sites lateral to the tibial tubercle should be avoided.
Authors: Akshar H Patel; J Heath Wilder; Olivia C Lee; Austin J Ross; Krishna C Vemulapalli; Paul B Gladden; Murphy P Martin; William F Sherman Journal: Orthop Rev (Pavia) Date: 2022-01-30
Authors: Pedro José Labronici; Ildeu Leite Moreira Junior; Fúbio Soares Lyra; José Sergio Franco; Rolix Hoffmann; Paulo Roberto Barbosa de Toledo Lourenço; Kodi Kojima; Kodi Kojima Journal: Rev Bras Ortop Date: 2015-11-17