Anatomic Description of the Distal Tibia: Implications for Internal Fixation

An Unexpected Intra-operative Encounter of Anterior Tibial Vessels Entrapment in the Fracture of Tibial Pilon: A Case Report and Literature Review

“…Proximity of anterior neurovascular structure to distal tibia, which are located at a mean of 3 mm from anterior tibial cortex, makes it vulnerable to injury in tibial pilon fractures and also during minimally invasive plating [4][5][6]. No such evidence is available in the literature hitherto of anterior vascular entrapment in tibial pilon fractures.…”

“…However, to the best of our knowledge, there is no such mention of neurovascular entrapment in tibial pilon fractures in literature. The anterior tibial vessels and the deep peroneal nerve are at such risk in cases of tibial pilon fractures due to its location in close proximity to distal tibia [4][5][6].…”

Influence of Ankle Position and Radiographic Projection Angle on Measurement of Supramalleolar Alignment on the Anteroposterior and Hindfoot Alignment Views

“…38 However, the tibia plafond is not flat but rather concave in shape, with an average medial angle of 22 ± 4 degrees at slight varus alignment. 1,21,25 Also, the subchondral bone plate is the cortical endplate located in the calcified region of the articular cartilage. 30 It has been demonstrated that subchondral mineralization is not homogeneously distributed across the articular surface of the distal tibia.…”

Fixation of a Distal Diaphyseal Tibia Fracture with Neurovascular Tissue Incarceration: Surgical Technique Using a Lesser Invasive Approach

“…In the human model, fractures treated conservatively may evolve towards non-union more frequently than those surgically fixed partly due to unrecognized loss of proper bone-tobone contact [16]. In the distal part of the leg, the tibialis anterior, extensor digitorum longus, and extensor hallucis longus muscles and tendons lie at an average of 6 mm from the anterior distal tibial surface, the closest being the tibialis anterior making this structure at particular risk [22]. The incidence of adverse bone healing due to soft-tissue interposition in distal tibia fractures is currently unknown.…”

“…The ATA and DPN lie at a mean distance of 3 mm from the anterior tibial cortex, making these neurovascular structures at risk of entrapment [22,24]. The ATA and the posterior tibial artery form a rich anastomotic arterial network supplying the external third of the distal tibial diaphysis [25].…”