Abstract: Objective To identify the exact anatomical tibial neurovascular bundle and measure the distance from external and posterior tibia. Through clearing the medial proximal tibia anatomical plate and screw fixation distribution region and examining the influence on the anterior neurovascular bundle, anatomic structures were determined when placing plates from proximal to dista along the medial border of the tibia and avoiding arteriae tibialis anterior and deep peroneal nerve injury. Methods 14 adult fresh specimens with lower extremity were performed. Plate and screws were fixed by imitating operative manipulation to identify the relationships between the plate/screws constructs and the pedicle containing the deep peroneal nerve and the anterior tibial vessels(DPN/ATV). Results The average tibia length was 39.5 cm. The danger zone for the arteriae tibialis anterior and deep peroneal nerve averaged of the tibia length from the medial tibial plateau were(17.7±3.3)cm(99%CI:42.4, 47.8). Conclusion From this anatomy study, the danger zone could be determined as a percentage of tibia length, then the injury could be avoided through the operation.

Key words: tibia fracture, minimally invasive percutaneous plate osteosynthesis, arteriae tibialis anterior injury, deep peroneal nerve injury, applied anatomy