Clinical Correlation Of Nutrient Foramen Of Dry Human Ulna Bones In Jammu Region

Background: The nutrient foramen of Human ulna bone is on the anterior surface of shaft of ulna almost proximalto the mid point and is directed upwards. Nutrient foramen permits the passage of the branch of anteriorinterosseous artery.Methods: The present study was conducted on 70 dry human ulna bones of unknown sex and age obtained fromGovernment Medical College Jammu. The Ulna bones were observed macroscopically for nutrient foramen.Results: In our study we observed that only 2 bones were without nutrient foramen and two of the bones with twonutrient foramen on right side while one foramen on all the left side. The location of nutrient foramen in right andleft ulna bones was 72% in the middle one third, 18% in upper third and 8% at the junction of upper and middleone third. The position of nutrient foramen was 80% on the anterior surface, 11% on the Interosseous border and7% on the anterior border. All the foramen were directed upwardsConclusion: The study of nutrient foramen is of utmost importance to the forensic experts as in determining thelength of ulna and to the orthopaedicians for deciding different treatment modalities in case of fractures of shaftof ulna so as to prevent non-union or avascular necrosis and also helpful for highly specialised surgicalprocedures like vascularised bone grafting involving microsurgery

Anomalous Origin of Anterior Interosseous Artery.

Background: The Brachial Artery ,usually a continuation of the axillary artery begins at the distal border of teres major and ends about a centimetre distal to the elbow joint by dividing into the radial and ulnar artery. Objectives: A. To document the origin of anterior interosseous artery from brachial artery. B. To establish embryological and clinico-anatomical correlation of such variations. Methods: These findings were observed after meticulous dissection of the upper limbs of both sides of a 43 year old adult male cadaver in the department of anatomy ,R .G .Kar Medical College ,Kolkata. Results: The brachial artery present in the right limb gave a branch in the upper 1/3 of the arm from its lateral aspect. This branch of brachial artery went downwards and became deep to pronator teres and continued as the anterior interosseous artery. The brachial artery itself descended and remained superficial to pronator teres. Just below the elbow joint it underwent bifurcation into radial and ulnar artery.The subsequent course of those two arteries was normal. And there was absence of common interosseous artery. So the anterior interosseous artery instead of arising from the common interosseous artery which was the branch of the ulnar artery took origin from brachial artery. Conclusion: This variation was explained in the light of embryological development and such variations were useful for physicians, surgeons, nephrologists ,radiologists and interventionist in various surgical procedures and also for diagnostic and therapeutic approaches.

Persistent Median Artery In the Carpal Tunnel.

Introduction: Persistent median artery originates from the anterior interosseous artery in proximal one-third of the forearm and accompanies median nerve. Median artery may regress in the forearm or enter palm through the carpal tunnel deep to flexor retinaculum of wrist and supply palm by anastomosing with the superficial palmar arch. Objective: In present study the objective was to study presence of persistent median artery accompanying median nerve and its termination Materials and Methods: The study included 50 human cadaver upper limb specimens at the Department of Anatomy, Mysore Medical College & Research Institute, Mysore during 2011-13. These specimens fixed in 10% formalin were finely dissected and persistent median artery was traced from origin to termination. Results: Out of 50 human cadaver specimens, persistent median artery was present in 4 specimens (8%). All the 4 median arteries originated from anterior interosseous artery and were of palmar type which reached palm. Out of 4 median arteries, 3 median arteries (6%) took part in completion of superficial palmar arch, supplying the distal aspect of palm and 1 median artery (2%) directly supplied radial two and half fingers without forming arch. Conclusion: Knowledge of unusual variations helps in proper treatment of disorders of the median nerve. Presence of persistent median artery usually will be asymptomatic but may cause symptoms of carpal tunnel syndrome or pronator teres syndrome when subjected to compression. Rarely this artery can be taken for reconstruction.

An anatomic study of the dorsal forearm perforator flaps / 中华显微外科杂志

Objective To provide anatomical landmarks with which to facilitate flap dissection,we studied the perforator artery of the dorsal forearm including its source,quantity,origination,caliber,variation and pedicle length. Methods Ten fresh cadavers were injected with a modified lead oxide-gelatin mixture,and three-dimensional graphics of the perforator vessels of the dorsal forearm were reconstructed with a computed tomography. In addition, twenty upper extremity specimens were injected with red latex via the axillary artery.The integument of the forearm was dissected,and perforators were identified,including type,course,size and location were documented.Surface areas were measured with Scion Image. Results The average number of the posterior interosseous artery cutaneous perforators in the dorsal forearm was (5±2),the average outer diameter of the perforator artories was (0.5 ± 0.1) mm,and the pedicle length was (2.5 ±0.2) cm.The average cutaneous vascular territory was (22.0 ± 15.0) cm2.The dorsal branch of the anterior interosseous artery dispersed on the wrist dorsum or the distal third of the dorsal forearm. It's average diameter was 0.8 mum. Conclusion The free transplantation of the posterior interosseous perforator artery flaps or rotary flap pedicled by the dorsal branch of the anterior interosseous artery for defect reconstruction are feasible.

Contribution of the anterior interosseous artery to the blood supply for posterior forearm region and applications in designing the posterior interosseous forearm flap

The anterior interosseous artery (AIA) plays an essential role in designing the posterior interosseous forearm flap (P.I.F.F). Understanding about anatomy of this artery permit us to find us to find out new solutions to design the P.I.F.F. in situations at which there are variations of the PIA. Objectives: (I) to evaluate the role of the anterior interosseous artery in the blood supplying to the posterior forearm region; (II) assessing the importance of anterior interosseous artery in designing the posterior interosseous forearm flap. Methods: 27 forearms of adults obove 25 years old, including 25 forearms fixed in formalin 4% and 2 fresh forearms, are objects for us to expose the AIA and PIA by different techniques. Results: There are 2-5 perforating branches of the AIA to the deep muscular layer of posterior. They connect to each other and to the muscular branch of the PIA, and their diameter becomes much larger in two cases of absence of the PIA. Branches from this series of arterial anastomoses distribute also to the skin of inferior half of posterior forearm. The posterior terminal branche of the AIA divides into the medial and recurrent branch. These two branches ascend and anastomose with the PIA and the muscular branch of the PIA, respectively. The medial branch of the posterior terminal branch is absent or disconnected with the PIA at two other cases. Conclusion: Our results indicate that the AiA supplies the inferior half and the deep muscular layer of the posterior forearm. The posterior interosseous forearm flap can still be raised in situations at which the posterior terminal branch of AIA communicates with the dorsal carpal arcus but not with the PIA and the PIA is absent.

Clinical application of pedicled flap supplied by radial osteo cutaneous branch of anterior interosseous artery / 中华显微外科杂志

Objective To expore the method of clinical application and the final result of pedicled flap supplied by radial osteo cutaneous branch of anterior interosseous artery Methods Basing on the anatomic basis that the osteo cutaneous and myocutaneous branches of the anterior interosseous artery have constant collateral anastomoses which can give forth a large size dorso radial flap on dorsum of the forearm Four cases of skin defect of first web had been reconstructed by this flap Results All 4 cases were successful with good functional and cosmetic results Conclusion Reconstruction with dorso radial flap of forearm is simple,reliable procedure which bring minimum trauma to the patient and is an ideal alternative operation