A comprehensive CT analysis of tibial nutrient artery anatomy: identifying critical areas to avoid in orthopedic procedures.

IF 1.4 4区医学 Q2 Medicine

Surgical and Radiologic Anatomy Pub Date : 2025-06-05 DOI:10.1007/s00276-025-03656-2

Nurcan Ercikti, Şeref Barbaros Arik

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引用次数: 0

Abstract

Purpose: This study aims to examine the location, number, course, and diameter of tibial nutrient canals in detail to minimize potential vascular damage during orthopedic interventions such as fracture fixation and bone graft procedures.

Methods: A total of 56 dry tibiae were scanned via CT with a slice thickness of 0.75 mm. The number, length, diameter, and location of the nutrient canals relative to the tibial plateau were recorded. Pearson correlation and Mann‒Whitney U tests were conducted to evaluate the relationships between the measured canal parameters and tibial metrics.

Results: Fifty-eight nutrient canals were identified. Among these, 98.27% were located within the distal portion of the proximal third or the proximal portion of the middle third of the tibia. The nutrient canals were predominantly concentrated (81.03%) in the posterolateral region, with the remainder distributed among the posterior, posteromedial, and anterolateral surfaces. The findings indicated that "the region with a high likelihood of encountering a nutrient canal" extends from approximately 6.96 cm to 22.75 cm along the tibial shaft, spanning a 135°-225° arc.

Conclusion: A detailed anatomical understanding of tibial nutrient arteries is essential for preserving blood flow and preventing iatrogenic vascular injuries in orthopedic procedures, particularly during internal fixation and graft applications. Identifying this "region with high nutrient canal density" may help reduce nutrient artery injury and promote faster fracture healing.

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胫骨营养动脉解剖的综合CT分析：确定矫形手术中应避免的关键区域。

目的：本研究旨在详细检查胫骨营养管的位置、数量、路线和直径，以尽量减少骨科干预（如骨折固定和骨移植手术）中潜在的血管损伤。方法：对56例干胫骨进行CT扫描，切片厚度为0.75 mm。记录营养管的数量、长度、直径和相对于胫骨平台的位置。采用Pearson相关检验和Mann-Whitney U检验来评估测量的椎管参数与胫骨指标之间的关系。结果：共鉴定营养管58条。其中98.27%位于胫骨近三分之一远端或中三分之一近端。营养管主要集中在后外侧（81.03%），其余分布在后、后内侧和前外侧。研究结果表明，“最有可能遇到营养管的区域”沿着胫骨轴延伸约6.96厘米至22.75厘米，跨度为135°-225°。结论：在骨科手术中，特别是在内固定和移植物应用过程中，对胫骨营养动脉的详细解剖了解对于保持血液流动和预防医源性血管损伤至关重要。确定这个“营养管密度高的区域”可能有助于减少营养动脉损伤，促进骨折更快愈合。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.