Document Detail

Danger zones associated with fibular osteotomy.
MedLine Citation:
PMID:  8169696     Owner:  NLM     Status:  MEDLINE    
Anatomic dissections were performed on five cadaveric lower extremities. Measurements of important neurovascular structures in relation to the fibula were obtained at 1-cm intervals along the length of the fibula with the tip of the fibular head as the reference point. Neurovascular structures adjacent to the fibula in danger of injury with fibular osteotomy were identified. At the proximal one-third of the fibula, the peroneal nerves and their muscular branches are at primary risk. The anterior tibial artery is vulnerable where it penetrates the interosseous membrane and where it runs adjacent to the fibula with the deep peroneal nerve. In the middle one-third of the fibula, the peroneal artery and vein are the major structures at risk. In the distal one-third of the fibula the peroneal vessels are at less risk because they branch and enter the region of the syndesmosis curving anteriorly. The other neurovascular structures are not adjacent to the fibula. Based on these data, general recommendations for fibular osteotomy include (a) placement of the osteotomy as distally along the shaft as is feasible, commensurate with the surgical goal; (b) direction of the osteotomy blade along a line connecting the axis of the fibula with the midpoint of the subcutaneous tibial surface in the proximal and middle one-third of the fibula; and (c) direction of the osteotomy blade from the axis of fibula to the anterior subcutaneous border of the tibia in the distal one-third of the fibula.
R E Rupp; D Podeszwa; N A Ebraheim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of orthopaedic trauma     Volume:  8     ISSN:  0890-5339     ISO Abbreviation:  J Orthop Trauma     Publication Date:  1994  
Date Detail:
Created Date:  1994-06-01     Completed Date:  1994-06-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8807705     Medline TA:  J Orthop Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  54-8     Citation Subset:  IM    
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo 43699.
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MeSH Terms
Fibula / anatomy & histology,  injuries,  surgery*
Osteotomy / adverse effects*
Peroneal Nerve / anatomy & histology,  injuries
Risk Factors
Tibial Arteries / anatomy & histology,  injuries

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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