Did you notice the tibial nutrient artery when applying external fixation?

摘要

We read with deep interest the article by Tong et al. [1]. We appreciate the work of the authors on the paper. However, Figs. 2 and 3 made us interested in the position of external fixation of the pilon fracture given by the authors. The authors stated Figs. 2 and 3 indicated that the three 4.5-mm pins were usually applied on the anterior surface of the proximal tibia. We found something interesting when following the instructions at our clinic, hi one patient, the proximal pins of the external fixation nearly penetrated the tibial nutrient artery (Fig. 1). According to previous studies, most people have only one tibial nutrient artery which supplies the inner two thirds of the cortex and is the chief blood supply of cortical bone [2]. It arises from the anterior aspect of the posterior tibial artery, very close to the origin of the latter from the popliteal artery.