Ercikti Nurcan, Barbaros Arik Şeref
Gulhane Medical Faculty, Department of Anatomy, Health Sciences University, Ankara, Turkey.
Department of Radiology, Yuksek Ihtisas University, Medicalpark Hospital, Ankara, Turkey.
Surg Radiol Anat. 2025 Jun 5;47(1):155. doi: 10.1007/s00276-025-03656-2.
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.
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.
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.
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.
本研究旨在详细检查胫骨滋养管的位置、数量、走行和直径，以尽量减少骨折固定和骨移植手术等骨科干预过程中潜在的血管损伤。
对56根干燥胫骨进行层厚0.75毫米的CT扫描。记录滋养管的数量、长度、直径以及相对于胫骨平台的位置。进行Pearson相关性分析和Mann-Whitney U检验，以评估所测滋养管参数与胫骨测量指标之间的关系。
共识别出58条滋养管。其中，98.27%位于胫骨近端三分之一的远端部分或中三分之一的近端部分。滋养管主要集中在（81.03%）后外侧区域，其余分布在后侧、后内侧和前外侧表面。研究结果表明，“滋养管高发现区域”沿胫骨干从约6.96厘米延伸至22.75厘米，跨越135°-225°弧度。
对胫骨滋养动脉进行详细的解剖学了解对于在骨科手术中，尤其是在内固定和植骨应用过程中保持血流和预防医源性血管损伤至关重要。识别这个“滋养管高密度区域”可能有助于减少滋养动脉损伤并促进骨折更快愈合。
