Cadaveric Analysis of Intramedullary Nail and Plate Fixation in Tibia-Fibula Fracture: Anatomical, Biomechanical and Functional Perspective

Abstract

Background: Cadaveric dissections serve as vital tools in medical education, providing detailed anatomical insights and fostering a deeper understanding of surgical interventions. The incidental identification of orthopaedic implants during dissection allows direct assessment of implant’s bone interaction, tissue response and biomechanical stability beyond radiological interpretation. This study documents the discovery of an intramedullary nail and screw fixation in the lower shaft of the tibia and fibula during routine cadaveric dissection. Objective: To document and analyse the anatomical, biomechanical and educational significance of an intramedullary nail and screw fixation in the tibia and plate fixation in the fibula observed during cadaveric dissection. Methodology: This descriptive cadaveric case based observational study was conducted on a 65-year-old male cadaver where metallic implants were incidentally identified. Systematic dissection was carried out to expose the tibia and fibula along with surrounding soft tissues. Implant configurations, bone-implant interface, periosteal integrity, fibrotic response and muscular changes were examined and documented. Results: A well aligned intramedullary nail extending from the proximal metaphysis to the distal shaft of the tibia was identified, secured by two proximal and one distal interlocking screws. The fibula showed lateral plate fixation with two cortical screws. Minimal fibrosis, intact periosteum and absence of osteolysis were observed. Mild muscle atrophy suggested previous immobilization rather than surgical complication. Conclusion: This cadaveric dissection demonstrates successful long term anatomical integration of tibia-fibula fixation. Such findings enhance understanding of fracture biomechanics, tissue response and provide valuable learning material for anatomical and surgical education.