Anatomical study of the placement of proximal oblique locking screws in intramedullary tibial nailing

Jones, B. G. and Mehin, R. and Young, D. (2007) Anatomical study of the placement of proximal oblique locking screws in intramedullary tibial nailing. Journal of Bone and Joint Surgery - British, 89 (11). pp. 1495-1497. ISSN 0301-620X

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Abstract

Intramedullary tibial nailing was performed in ten paired cadavers and the insertion of a medial-to-lateral proximal oblique locking screw was simulated in each specimen. Anatomical dissection was undertaken to determine the relationship of the common peroneal nerve to the cross-screw. The common peroneal nerve was contacted directly in four tibiae and the cross-screw was a mean of 2.6 mm (1.0 to 10.7) away from the nerve in the remaining 16. Iatrogenic injury to the common peroneal nerve by medial-to-lateral proximal oblique locking screws is therefore a significant risk during tibial nailing.