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Lateral radiograph of the knee
76%
982/1291
AP radiograph of the knee
2%
26/1291
Oblique radiographs of the knee
6%
74/1291
Merchant radiograph of the knee
9%
112/1291
Internally rotated 45 degree view of the knee
7%
93/1291
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The safe zone for tibial nail placement as seen on radiographs is just medial to the lateral tibial spine on the anteroposterior radiograph and immediately adjacent and anterior to the articular surface as visualized on the lateral radiograph. Tornetta et al specifically located the safe zone for nail entry in a study using fresh frozen cadaver knees. The authors found that the safe zone for nail placement is located 9.1+/-5 millimeters lateral to the midline of the plateau and three millimeters lateral to the center of the tibial tubercle. The width of the safe zone averaged 22.9 millimeters and was as narrow as 12.6 millimeters. The starting point of the of the nail can be best viewed on the lateral knee radiograph, an example of which is shown in Illustration A. Illustration B shows the "sweet spot" for nail insertion as defined by Tornetta.
2.9
(30)
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