Cadaveric study (n=20) using K-wires placed in the anatomically defined safe zone for tibial nail portal placement, then fluoroscoped to identify the AP and lateral radiographic landmarks surgeons can use intraoperatively to avoid intraarticular injury.
When starting a tibial nail, confirm on AP fluoroscopy that your portal is just medial to the lateral tibial spine (never past the medial spine), then use the lateral view — which shows no anatomic variance. To verify the entry point is immediately anterior to the articular margin before reaming.
Cadaveric study (n=20) using K-wires placed in the anatomically defined safe zone for tibial nail portal placement, then fluoroscoped to identify the AP and lateral radiographic landmarks surgeons can use intraoperatively to avoid intraarticular injury.
When starting a tibial nail, confirm on AP fluoroscopy that your portal is just medial to the lateral tibial spine (never past the medial spine), then use the lateral view — which shows no anatomic variance. To verify the entry point is immediately anterior to the articular margin before reaming.