by AceMedEd

Teach card · keep it in your scrub pocket

Tibial shaft fracture

Ask during the case

  1. Positioning and the first fluoroscopy shots: "Show me the start point on the AP and on the lateral. What deformity follows a start point that is too medial, or too low on the front of the tibia?"
  2. While the proximal locking screw goes in: "Which nerve is near the far end of this oblique screw, and how will you examine it on the ward tonight?"
  3. At the final images: "How do we know the alignment is right? What should the knee and ankle joint lines do, and how will we check rotation before we leave the room?"

Point at: the start point on the fluoroscopy screen, on the AP and then the lateral, before the guidewire goes in, while they name the landmark on each view.

End of day: "Draw me an AP and a lateral of the tibia with the start point and the distal target, then the mid-leg slice with the four compartments and the nerve in each." Two minutes, no notes.

Where this kit and your technique differ, yours wins.

Send this to your students

The night before. They prep alone, redraw at turnover, and get a cold check tomorrow morning. They won't see these questions.

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Reviewed by Mehdi “AC” Talle, D.O., November 2026. Sources: Netter, Gray's Anatomy and Hoppenfeld's surgical exposures, with Rockwood and Green for fractures. Teaching schematic, not to scale; anatomy and technique vary. Management and indications are left to you on purpose.