Objective: To identify the radiographic correlate of the anatomic safe zone
for tibial portal placement.
Design: Cadaveric, anatomic, and radiographic study using twenty cadaveric
knees. Kirschner wires were placed in the anatomic safe zone. Anteroposteri
or and lateral radiographs were taken to evaluate the portal placement.
Setting: Anatomy laboratory.
Outcome measurements: Radiographic measurements of Kirschner wires placed i
n 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 a
nd immediately adjacent and anterior to the articular surface as visualized
on the lateral radiograph. There is some variance on the anteroposterior r
adiograph but no variance on the lateral radiograph.
Conclusions: The placement of tibial nails in the superior portion of the t
ibia in the documented position generates the least risk to the intraarticu
lar structures of the knee.