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Trauma: B. G. Jones, R. Mehin, and D. Young Anatomical study of the placement of proximal oblique locking screws in intramedullary tibial nailing J Bone Joint Surg Br 2007; 89-B: 1495-1497 [Abstract] [Full text] [PDF]

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Internally rotating nail to preserve common peroneal. Can it be more dangerous?

K. Bahadir Alemdaroglu, Serkan Iltar, Nevres H. Aydogan   (1 February 2008)

Internally rotating nail to preserve common peroneal. Can it be more dangerous? 1 February 2008
K. Bahadir Alemdaroglu, Specialist in Orthopaedics Ankara Training and Research Hospital, Serkan Iltar, Nevres H. Aydogan Send letter to journal: Re: Internally rotating nail to preserve common peroneal. Can it be more dangerous? balemdaroglu{at}yahoo.com.tr K. Bahadir Alemdaroglu, et al.	Sir, We read this article with great interest. It gives adequate information about the anatomical features of proximal medial to lateral oblique interlocking of an intramedullary nail. We agree with the unsafe localisation of this screw. In our experience, it is usually impractical as it is located proximally where the cortices are thin so that it makes the fixation insecure, particularly in older patients. Internally rotated position of the nail can occur with over-drilling of the entry point of the nail. However, this position will be extremely dangerous for the posterior tibial artery, nerve and vein when internal rotation exceeds even 10°. K.B. Alemdaroglu, S. Iltar, N.H. Aydogan, Ankara Training and Research Hospital Ankara, Turkey.