Pediatric orthopaedic surgeon R. Jay Lee discusses his latest research “Minimizing the Risk of Vascular Injury: Anatomy of the Popliteal Artery in the Pediatric Knee".
Read the paper: pubmed.ncbi.nlm.nih.gov/35819314 .
to be a typical fractures are most commonly seen in adolescent patients, they occur from quadriceps traction on the table to brickell during jumping and landing or during collision in contact sports. These fractures are typically treated with reduction and screw fixation. A clear understanding of the local anatomical landmarks and vascular structures are essential as the screws traverse the proximal tibia from an anterior to post your direction headed in the direction of the tibial neurovascular bundle. The current literature on safe zones in the proximal tibia are based off of small samples of adult patients, so we aim to characterize the an atomic variation of the pop little artery amongst the pediatric population so we can recommend a safe screw trajectory for surgical treatment of tibial typical fractures and kids. We sampled a group of patients from 12 to 17, the common age group for these fractures and mapped out their nerve vascular structures. We found that the political artery was latterly positioned in all knees, but close to the post your cortex and at risk with drilling. However, even accounting for the outliers, there's a reasonable safe zone in pediatric patients on the medial aspect of the tibia, in the corona plane, Because the arteries close to the Tibia at all levels, a drill exiting in line with the popular artery risk vascular injury. Therefore, we recommend in our manuscript that the screws exit within the medial, 60% of the Tibia. Understanding this concept and the course of the pop little artery in pediatric patients allow surgeons to more securely fix the tibial to brickell and still protect the adjacent vital structures.