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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 11, 1495-1497.
doi: 10.1302/0301-620X.89B11.19018  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Anatomical study of the placement of proximal oblique locking screws in intramedullary tibial nailing

B. G. Jones, FRCS Ed (Trauma&Orth), Orthopaedic Surgeon1; R. Mehin, MD, FRCS(C), Orthopaedic Surgeon2; and D. Young, PhD, Statistician3

1 Orthopaedic Department Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK.
2 2179 McCallum Road, Abbotsford, British Columbia, Canada V2S-3DI.
3 Department of Statistics and Modelling Science University of Strathclyde, Livingstone Tower, Richmond Street, Glasgow G1 1XH, UK.

Correspondence should be sent to Mr B. G. Jones; e-mail: Bryn-jones{at}northglasgow.scot.nhs.uk

Intramedullary tibial nailing was performed in ten paired cadavers and the insertion of a medial-to-lateral proximal oblique locking screw was simulated in each specimen. Anatomical dissection was undertaken to determine the relationship of the common peroneal nerve to the cross-screw.

The common peroneal nerve was contacted directly in four tibiae and the cross-screw was a mean of 2.6 mm (1.0 to 10.7) away from the nerve in the remaining 16. Iatrogenic injury to the common peroneal nerve by medial-to-lateral proximal oblique locking screws is therefore a significant risk during tibial nailing.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General