Tibial portal placement: the radiographic correlate of the anatomic safe zone.
OBJECTIVE
To identify the radiographic correlate of the anatomic safe zone for tibial portal placement.


METHODS
Cadaveric, anatomic, and radiographic study using twenty cadaveric knees. Kirschner wires were placed in the anatomic safe zone. Anteroposterior and lateral radiographs were taken to evaluate the portal placement.


METHODS
Anatomy laboratory.


METHODS
Radiographic measurements of Kirschner wires placed in the anatomic safe zone.


RESULTS
The safe zone for tibial nail placement as seen on radiographs is just medial to the lateral tibial spine on the anteroposterior radiograph and immediately adjacent and anterior to the articular surface as visualized on the lateral radiograph. There is some variance on the anteroposterior radiograph but no variance on the lateral radiograph.


CONCLUSIONS
The placement of tibial nails in the superior portion of the tibia in the documented position generates the least risk to the intraarticular structures of the knee.
Boston Medical Center, 850 Harrison Avenue, Boston, MA 02118, U.S.A.
T
T
McConnell
P
P
Tornetta
J
J
Tilzey
D
D
Casey
D001858:Bone Nails; D002102:Cadaver; D004869:Equipment Safety; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013978:Tibial Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*