A Cadaveric Finding of Intramedullary Nail Implant and Screw Fixation in the Lower Shaft of Tibia and Fibula During Dissection: An Experience

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 finding of orthopaedic implants, such as intramedullary nails and screws, offers a unique opportunity to study their clinical implications, biomechanical efficacy, and postoperative anatomical integration. 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 describe the cadaveric finding of an intramedullary nail and screw fixation in the tibia and fibula, analyze the implant's biomechanical and anatomical significance, and discuss its educational relevance. Materials and Methods: During routine dissection of a 65-year-old male cadaver in a medical anatomy lab, metallic implants were observed in the lower left leg. Detailed dissection was performed to expose the tibia and fibula, with emphasis on the implant, surrounding anatomical structures, and tissue changes. Standard surgical tools, including scalpel blades, forceps, and protective equipment, were utilized. Anatomical and biomechanical features of the implant were documented and analyzed. Results: An intramedullary nail, extending from the proximal metaphysis to the distal tibial shaft, was identified, secured with two proximal and one distal interlocking screw. The fibula was stabilized with a lateral plate and two screws. The implants were composed of AISI 316L stainless steel, with minimal fibrotic changes and intact periosteum observed around the nail. The musculature of the lower limb showed mild atrophy, likely due to immobilization. Biomechanically, the nail and screws provided axial and rotational stability, promoting primary bone healing and minimizing complications such as malalignment or implant failure. Conclusion: This cadaveric finding underscores the importance of intramedullary nail and screw fixation in managing tibial fractures, highlighting the biomechanical and clinical relevance of such interventions. It also emphasizes the educational value of integrating cadaveric observations of surgical implants into medical training. Further studies on similar findings can enhance understanding of implant performance and improve orthopedic outcomes.