{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:00:44Z","timestamp":1792800044918,"version":"4.5.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,5,21]],"date-time":"2019-05-21T00:00:00Z","timestamp":1558396800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,5,21]],"date-time":"2019-05-21T00:00:00Z","timestamp":1558396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Conventional anatomically contoured plates do not adequately fit most tibiae. This emphasizes the need for a more thorough morphological study. Statistical shape models are promising tools to display anatomical variations within a population. Herein, we aim to provide a better insight into the anatomical variations of the tibia and tibia plateau. Seventy-nine CT scans of tibiae were segmented, and a principal component analysis was performed. Five morphologically important parameters were measured on the 3D models of the mean tibial shapes as well as the \u22123SD and +3\u2009SD tibial shapes of the first five components. Longer, wider tibiae are related to a more rounded course of the posterior column, a less prominent tip of the medial malleolus, and a more posteriorly directed fibular notch. Varus\/valgus deformations and the angulation of the posterior tibia plateau represent only a small percentage of the total variation. Right and left tibiae are not always perfectly symmetrical, especially not at the level of the tibia plateau. The largest degree of anatomical variation of the tibia is found in its length and around the tibia plateau. Because of the large variation in the anatomy, a more patient-specific approach could improve implant fit, anatomical reduction, biomechanical stability and hardware-related complications.<\/jats:p>","DOI":"10.1038\/s41598-019-44092-8","type":"journal-article","created":{"date-parts":[[2019,5,21]],"date-time":"2019-05-21T10:11:42Z","timestamp":1558433502000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Anatomical Variation of the Tibia \u2013 a Principal Component Analysis"],"prefix":"10.1038","volume":"9","author":[{"given":"Liselore","family":"Quintens","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0010-4446","authenticated-orcid":false,"given":"Michiel","family":"Herteleer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanne","family":"Vancleef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannick","family":"Carette","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost","family":"Duflou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefaan","family":"Nijs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos Vander","family":"Sloten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harm","family":"Hoekstra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,5,21]]},"reference":[{"key":"44092_CR1","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1097\/BOT.0b013e3181d436f3","volume":"24","author":"CF Luo","year":"2010","unstructured":"Luo, C. F., Sun, H., Zhang, B. & Zeng, B. F. Three-column fixation for complex tibial plateau fractures. J Orthop Trauma 24, 683\u2013692 (2010).","journal-title":"J Orthop Trauma"},{"key":"44092_CR2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-016-0696-z","author":"H Hoekstra","year":"2016","unstructured":"Hoekstra, H., Kempenaers, K. & Nijs, S. A revised 3-column classification approach for the surgical planning of extended lateral tibial plateau fractures. Eur. J. Trauma Emerg. Surg. https:\/\/doi.org\/10.1007\/s00068-016-0696-z (2016).","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"44092_CR3","doi-asserted-by":"publisher","first-page":"2252","DOI":"10.1016\/j.injury.2018.11.010","volume":"49","author":"M Kfuri","year":"2018","unstructured":"Kfuri, M. & Schatzker, J. Revisiting the Schatzker classification of tibial plateau fractures. Injury 49, 2252\u20132263 (2018).","journal-title":"Injury"},{"key":"44092_CR4","doi-asserted-by":"publisher","first-page":"1488","DOI":"10.1016\/j.injury.2016.04.026","volume":"47","author":"Y Wang","year":"2016","unstructured":"Wang, Y. et al. Updated Three-Column Concept in surgical treatment for tibial plateau fractures - A prospective cohort study of 287 patients. Injury 47, 1488\u201396 (2016).","journal-title":"Injury"},{"key":"44092_CR5","doi-asserted-by":"publisher","first-page":"1865","DOI":"10.1007\/s00264-017-3566-3","volume":"41","author":"J van den Berg","year":"2017","unstructured":"van den Berg, J. et al. Functional outcome of intra-articular tibial plateau fractures: the impact of posterior column fractures. Int. Orthop. 41, 1865\u20131873 (2017).","journal-title":"Int. Orthop."},{"key":"44092_CR6","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1055\/s-0035-1564729","volume":"29","author":"A Jiwanlal","year":"2016","unstructured":"Jiwanlal, A. & Jeray, K. J. ame. Outcome of Posterior Tibial Plateau Fixation. The journal of knee surgery 29, 34\u201339 (2016).","journal-title":"The journal of knee surgery"},{"key":"44092_CR7","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s13018-017-0531-1","volume":"12","author":"P Chen","year":"2017","unstructured":"Chen, P. et al. Newly designed anterolateral and posterolateral locking anatomic plates for lateral tibial plateau fractures: a finite element study. J. Orthop. Surg. Res. 12, 35 (2017).","journal-title":"J. Orthop. Surg. Res."},{"key":"44092_CR8","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1055\/s-0036-1593366","volume":"30","author":"V Giordano","year":"2017","unstructured":"Giordano, V., Schatzker, J. & Kfuri, M. The \u201cHoop\u201d Plate for Posterior Bicondylar Shear Tibial Plateau Fractures: Description of a New Surgical Technique. J. Knee Surg. 30, 509\u2013513 (2017).","journal-title":"J. Knee Surg."},{"key":"44092_CR9","doi-asserted-by":"publisher","first-page":"2631","DOI":"10.1007\/s00264-017-3602-3","volume":"41","author":"H Hoekstra","year":"2017","unstructured":"Hoekstra, H. Are there four tibia plateau columns? Int. Orthop. 41, 2631\u20132632 (2017).","journal-title":"Int. Orthop."},{"key":"44092_CR10","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-34818-5","volume":"8","author":"D Ren","year":"2018","unstructured":"Ren, D., Liu, Y., Lu, J., Xu, R. & Wang, P. A Novel Design of a Plate for Posterolateral Tibial Plateau Fractures Through Traditional Anterolateral Approach. Sci. Rep. 8, 16418 (2018).","journal-title":"Sci. Rep."},{"key":"44092_CR11","doi-asserted-by":"publisher","first-page":"012","DOI":"10.1055\/s-0035-1564731","volume":"29","author":"M Garner","year":"2015","unstructured":"Garner, M., Warner, S. & Lorich, D. Surgical Approaches to Posterolateral Tibial Plateau Fractures. J. Knee Surg. 29, 012\u2013020 (2015).","journal-title":"J. Knee Surg."},{"key":"44092_CR12","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1002\/ajpa.1098","volume":"116","author":"TW Holliday","year":"2001","unstructured":"Holliday, T. W. & Ruff, C. B. Relative variation in human proximal and distal limb segment lengths. Am. J. Phys. Anthropol. 116, 26\u201333 (2001).","journal-title":"Am. J. Phys. Anthropol."},{"issue":"4","key":"44092_CR13","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1080\/10255842.2010.482044","volume":"14","author":"Beat Schmutz","year":"2011","unstructured":"Schmutz, B. et al. Computer Methods in Biomechanics and Biomedical Engineering Fit optimisation of a distal medial tibia plate Fit optimisation of a distal medial tibia plate., https:\/\/doi.org\/10.1080\/10255842.2010.482044 (2016).","journal-title":"Computer Methods in Biomechanics and Biomedical Engineering"},{"key":"44092_CR14","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1097\/BLO.0b013e31809e6e45","volume":"461","author":"KS Goyal","year":"2007","unstructured":"Goyal, K. S., Skalak, A. S., Marcus, R. E., Vallier, H. A. & Cooperman, D. R. Analysis of anatomic periarticular tibial plate fit on normal adults. Clin. Orthop. Relat. Res. 461, 245\u201357 (2007).","journal-title":"Clin. Orthop. Relat. Res."},{"key":"44092_CR15","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1111\/joa.12900","volume":"234","author":"N T\u00fcmer","year":"2019","unstructured":"T\u00fcmer, N. et al. Three-dimensional analysis of shape variations and symmetry of the fibula, tibia, calcaneus and talus. J. Anat. 234, 132\u2013144 (2019).","journal-title":"J. Anat."},{"key":"44092_CR16","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/S0020-1383(18)30312-7","volume":"49","author":"A Petersik","year":"2018","unstructured":"Petersik, A. et al. A numeric approach for anatomic plate design. Injury. 49, 96\u2013101 (2018).","journal-title":"Injury."},{"key":"44092_CR17","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.media.2010.02.008","volume":"14","author":"N Kozic","year":"2010","unstructured":"Kozic, N. et al. Optimisation of orthopaedic implant design using statistical shape space analysis based on level sets. Med Image Anal. 14, 265\u201375 (2010).","journal-title":"Med Image Anal."},{"key":"44092_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2018.09.018","author":"S Vancleef","year":"2019","unstructured":"Vancleef, S. et al. Why off-the-shelf clavicle plates rarely fit: anatomic analysis of the clavicle through statistical shape modeling. J. Shoulder Elb. Surg. https:\/\/doi.org\/10.1016\/j.jse.2018.09.018 (2019).","journal-title":"J. Shoulder Elb. Surg."},{"key":"44092_CR19","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1016\/S0021-9290(01)00222-6","volume":"35","author":"G Wu","year":"2002","unstructured":"Wu, G. et al. ISB recommendation on definitions of joint coordinate system of various joints for the reporting of human joint motion\u2013part I: ankle, hip, and spine. International Society of Biomechanics. J. Biomech. 35, 543\u20138 (2002).","journal-title":"J. Biomech."},{"key":"44092_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/00140139.2019.1581262","volume":"19","author":"F Danckaers","year":"2019","unstructured":"Danckaers, F. et al. Posture normalization of 3D body scans. Ergonomics. 19, 1\u201321 (2019).","journal-title":"Ergonomics."},{"key":"44092_CR21","doi-asserted-by":"publisher","DOI":"10.1109\/CVPR.2007.383165","author":"B Amberg","year":"2007","unstructured":"Amberg, B., Romdhani, S. & Vetter, T. Optimal step nonrigid ICP algorithms for surface registration. Proceedings of the IEEE Computer Society Conference on Computer Vision and Pattern Recognition. https:\/\/doi.org\/10.1109\/CVPR.2007.383165 (2007).","journal-title":"Proceedings of the IEEE Computer Society Conference on Computer Vision and Pattern Recognition"},{"key":"44092_CR22","first-page":"38","volume":"17","author":"E Hoffmann","year":"2014","unstructured":"Hoffmann, E. et al. Closing or opening wedge high tibial osteotomy: watch out for the slope. Oper Tech Orthop. 17, 38\u201345 (2014).","journal-title":"Oper Tech Orthop."},{"key":"44092_CR23","doi-asserted-by":"crossref","first-page":"43","DOI":"10.55095\/achot2016\/007","volume":"83","author":"M Erdil","year":"2016","unstructured":"Erdil, M. et al. The Effect of Sagittal Plane Deformities after Tibial Plateau Fractures to Functions and Instability of Knee Joint. Acta Chir. Orthop. Traumatol. Cech. 83, 43\u201346 (2016).","journal-title":"Acta Chir. Orthop. Traumatol. Cech."},{"key":"44092_CR24","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.1016\/j.medengphy.2014.09.007","volume":"36","author":"S Radzi","year":"2014","unstructured":"Radzi, S. et al. Assessing the bilateral geometrical differences of the tibia \u2013 Are they the same? Med Eng Phys. 36, 1618\u201325 (2014).","journal-title":"Med Eng Phys."},{"key":"44092_CR25","doi-asserted-by":"publisher","first-page":"307","DOI":"10.5792\/ksrr.16.076","volume":"29","author":"K-M Jang","year":"2017","unstructured":"Jang, K.-M. et al. Three-Dimensional Evaluation of Similarity of Right and Left Knee Joints. Knee Surg. Relat. Res. 29, 307\u2013315 (2017).","journal-title":"Knee Surg. Relat. Res."},{"key":"44092_CR26","doi-asserted-by":"publisher","first-page":"e50","DOI":"10.2106\/JBJS.17.00829","volume":"100","author":"L Vlachopoulos","year":"2019","unstructured":"Vlachopoulos, L. et al. Restoration of the patient-specific anatomy of the proximal and distal parts of the humerus: Statiscal shape modeling versus contralateral registration method. J Bone Joint Surg Am. 100, e50 (2019).","journal-title":"J Bone Joint Surg Am."},{"key":"44092_CR27","doi-asserted-by":"publisher","first-page":"e3","DOI":"10.2106\/JBJS.RVW.O.00057","volume":"4","author":"R Ahmad","year":"2016","unstructured":"Ahmad, R., Patel, A., Mandalia, V. & Toms, A. Posterior Tibial Slope: Effect on, and Interaction with, Knee Kinematics. JBJS Rev. 4, e3\u2013e3 (2016).","journal-title":"JBJS Rev."},{"key":"44092_CR28","first-page":"1","volume":"31","author":"B Meulenkamp","year":"2016","unstructured":"Meulenkamp, B. et al. Incidence, Risk Factors And Location Of Articular Malreductions Of The Tibial Plateau. J. Orthop. Trauma 31, 1 (2016).","journal-title":"J. Orthop. Trauma"},{"key":"44092_CR29","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1016\/j.knee.2014.09.011","volume":"21","author":"TK Timmers","year":"2014","unstructured":"Timmers, T. K., van der Ven, D. J. C., de Vries, L. S. & van Olden, G. D. J. Functional outcome after tibial plateau fracture osteosynthesis: A mean follow-up of 6 years. Knee 21, 1210\u20131215 (2014).","journal-title":"Knee"},{"key":"44092_CR30","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.1016\/j.injury.2015.05.035","volume":"46","author":"RLM Van Dreumel","year":"2015","unstructured":"Van Dreumel, R. L. M., Van Wunnik, B. P. W., Janssen, L., Simons, P. C. G. & Janzing, H. M. J. Mid- to long-term functional outcome after open reduction and internal fixation of tibial plateau fractures. Injury 46, 1608\u20131612 (2015).","journal-title":"Injury"},{"key":"44092_CR31","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1007\/s00264-009-0790-5","volume":"34","author":"N Manidakis","year":"2010","unstructured":"Manidakis, N. et al. Tibial plateau fractures: Functional outcome and incidence of osteoarthritis in 125 cases. Int. Orthop. 34, 565\u2013570 (2010).","journal-title":"Int. Orthop."},{"key":"44092_CR32","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1007\/s00264-013-2174-0","volume":"38","author":"G Mattiassich","year":"2014","unstructured":"Mattiassich, G. et al. Radiographic and Clinical Results after Surgically Treated Tibial Plateau Fractures at Three and Twenty Two Years Postsurgery. Int. Orthop. 38, 587\u2013594 (2014).","journal-title":"Int. Orthop."},{"key":"44092_CR33","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1080\/10255842.2016.1265110","volume":"20","author":"P Vanden Berghe","year":"2017","unstructured":"Vanden Berghe, P., Demol, J., Gelaude, F. & Vander Sloten, J. Virtual anatomical reconstruction of large acetabular bone defects using a statistical shape model. Comput. Methods Biomech. Biomed. Engin. 20, 577\u2013586 (2017).","journal-title":"Comput. Methods Biomech. Biomed. Engin."},{"key":"44092_CR34","doi-asserted-by":"crossref","unstructured":"Poltaretskyi, S. et al. Prediction of the pre-morbid 3D anatomy of the proximal humerus based on statistical shape modelling. Bone Joint J. 99\u2013B (2017).","DOI":"10.1302\/0301-620X.99B7.BJJ-2017-0014"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-44092-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-44092-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-44092-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T19:44:47Z","timestamp":1694893487000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-44092-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,21]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["44092"],"URL":"https:\/\/doi.org\/10.1038\/s41598-019-44092-8","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,21]]},"assertion":[{"value":"29 January 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"7649"}}