Assessment of Relationship Between Neck Shaft Angle and Neck Length with Interepicondylar Distance in Femur.

Background: Femur is the longest and strongest bone of the body. It transmits body weight from hip bone to tibia in standing position. Femoral neck is a constricted part connecting head with shaft at an angle of about 125°- known as angle of inclination or neck shaft angle (NSA); this facilitates the movement of hip joint enabling the limb to swing clear of pelvis. Abnormal femoral neck angle (FNA) may be associated with various clinical problems ranging from harmless in toeing gait in childhood to disabling osteoarthritis in adults. The current study attempted to find out if a co-relation exists between those parameters and other clinically measurable variables like inter-epicondylar distance or distance between greater trochanter to lateral epicondyle. This may help to predict the risk of fracture neck femur without any risk of radiation exposure and proper prophylactic measures can be undertaken (Vit-D, calcium) to decrease risk of fracture. Results: Measurements were taken in dry femora mostly in East Indian population. Variables that were measured in 158 dry femora (85 femora from left side and 73 from the right side) are: - a) Neck shaft angle of femur, b) Neck length of femur, c) Neck circumference of femur, d) Inter-epicondylar distance of femur, e) Distance between lateral epicondyle and greater trochanter of femur. No significant difference was found between the right and left sided femoral groups regarding any of the study variables. From the analysis it was revealed that no positive or negative correlation exists between the study variables. Therefore, it is not possible to predict the value of one or more of them from the magnitude of the other variable(s). Conclusions: Our study attempted to find out if it was possible to predict the risk of fracture neck femur by simple clinical procedure without exposing the subjects to radiation hazards associated with a radiological imaging. A screening test and subsequent prophylactic measures could have been suggested to prevent the fracture. However, at the end of the study, no suitable alternative to the radiological assessment was detected.

Anomalous Branches of Median Nerve In The Arm.

Background: Dissection of right and left upper limbs and demonstration of the origin and the course ofmedian nerve. Result: Median nerve in the right upper limb is formed normally but it supplies brachialis muscle and both head of the biceps in the armwhich is anomalous. In the left arm of the patient the course and supply of median nerve is normal. Conclusion: The patient has unilateral anomalous supply of median nerve in the arm – this can result in trauma to this nerve while undergoing any surgery in right arm.

Anomalous Origin of Left Vertebral Artery.

Background: To document the unusual origin of left vertebral artery from the arch of aorta and to discuss the embryological basis and clinico-anatomical correlation of such variation. Materials and Methods: This finding was seen after thorough and meticulous dissection of the thorax in a 58 year old male cadaver in the department of anatomy, R.G.Kar Medical College. Results: There was anomalous origin of the left vertebral artery from the arch of aorta whereas the right vertebral artery took its normal origin from right subclavian artery. Conclusion: This anatomical variation can be explained in the light of embryological development .In addition knowledge of such variation is important for carrying out surgical procedures.

Anomalous Origin of Right Inferior Phrenic Artery.

Background: To show the anomalous origin of right inferior phrenic artery from right renal artery and to discuss the embryological basis and surgical significance of such variation. Method: This was found during routine dissection of abdomen in a 61 year old adult male cadaver in the department of anatomy, R.G.Kar Medical College. Results: It was seen that right inferior phrenic artery(RIPA) took its origin from right renal artery. Further distribution of RIPA was normal. Left inferior phrenic artery (LIPA) arose normally from abdominal aorta. Conclusion: Accurate knowledge regarding this is important for carrying out vascular and reconstructive surgery and for evaluation of angiographic images . The RIPA is a major source of collateral arterial supply to hepatocellular carcinoma, second only to the hepatic artery. So a surgically inoperable HCC can be treated by transcatheter embolization of not only the right or left hepatic arteries, but also by embolization of a RIPA, if involved.