Anatomical Characteristics of the Cast Tibial Intraosseous Artery

Abstract

Abstract Background Nonunion after tibial fracture is predominantly related to insufficient blood supply. Characterization of the anatomy of the tibial intraosseous artery is necessary to explore and develop therapeutic measures to prevent nonunion. However, quantitative indicators related to the tibial intraosseous artery are currently lacking. This study aimed to prepare pig tibia specimens with exposed intraosseous arteries and use these specimens to examine the anatomical characteristics of tibial intraosseous arteries. Methods Twenty isolated pig right legs with intact blood vessels were used to create cast specimens of the porcine tibia intraosseous artery by the perfusion corrosion method. The course, distribution, and branches of the intraosseous nutrient artery were observed with naked eye and optical microscopy. Intraosseous arteries with a diameter of ≥ 0.3 mm were counted and their diameters were measured using a microscopic ruler. The spatial distribution of each artery branch was determined using a circular protractor and a laser generator, and the obtained data were statistically analyzed. Results Porcine tibial intraosseous artery cast specimens were successfully produced and intraosseous arteries were clearly visible. The internal tibial artery is divided into the main trunk of the ascending and descending branches. The main trunk of the ascending branch sends out two primary branches, and each primary branch sends out 1–3 secondary branches. The branches are connected by communicating branches to form a circular anastomosis and merge into the proximal tibia. The main trunk of the descending branch descends for a certain distance in the medullary cavity and then divides into two primary branches, with each primary branch further dividing into 1–3 tree-like secondary branches that merge into the distal end of the tibia. The number of ascending and descending secondary branches of intraosseous arteries (diameter ≥ 0.3 mm) were 3.5 ± 0.71 and 2.63 ± 0.59, respectively, and the diameters of these branches were 0.56 ± 0.09 and 0.57 ± 0.11 mm, respectively. Conclusion This study quantitatively described the diameter, number, and distribution of pig tibial intraosseous arteries and provides a potential new method to study human tibial intraosseous arteries. Furthermore, these findings provide guidance for safe intraoperative fixation and reconstruction of blood supply to the broken end of the tibia.