A Comprehensive CT Analysis of Tibial Nutrient Artery Anatomy: Identifying Critical Areas to Avoid in Orthopedic Procedures

Purpose This study aims to examine the location, number, course, and diameter of tibial nutrient arteries in detail to minimize potential vascular damage during orthopedic interventions such as fracture fixation and bone graft procedures. Methods A total of 56 dry tibiae were scanned using CT with a slice thickness of 0.75 mm. The number, length, diameter, and location of the nutrient arteries relative to the tibial plateau were recorded. Pearson correlation and Mann-Whitney U tests were conducted to evaluate the relationships between the measured artery parameters and tibial metrics. Result Fifty-eight nutrient arteries were identified. Of these, 98.27% were located within the distal portion of the proximal third or the proximal portion of the middle third of the tibia. Nutrient arteries were predominantly concentrated (81.03%) in the posterolateral region, with the remainder distributed among the posterior, posteromedial, and anterolateral surfaces. The findings indicated a “high-risk” area extending from approximately 6.96 cm to 22.75 cm along the tibial shaft, spanning a 135°–225° arc. Conclusion 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 “high-risk zone” may help reduce complications and promote faster fracture healing.