Evaluation of Nutrient Foramina of the Dry Adult Human Femur Bone of North Indian Population

Introduction: The Femur bone is a highly vascular structure with unique features in its blood supply via numerous foramina located over its different segments, being named as vascular foramina . Among vascular foramina, nutrient foramen is an important one which gives way to the nutrient artery. Aim: To evaluate the nutrient foramina of the dry adult human femur bone of north Indian population. Subjects and Methods: The present study was undertaken using 50 dry adult human Femur bones of North Indian population. The samples were collected from the Anatomy department of the institute. Results: In the present study, among foramina of 50 dry adult human Femora, 31 Femora had single nutrient foramen, 18 had two nutrient foramina and 1 had three nutrient foramina. The medial lip of lineaaspera of Femur depicted the presence of nutrient foramina in majority of bones suggesting the entry zone for nourishment of shaft by perforating arteries. Size of nutrient foramina were ranging from size ≥ 0.55 mm to size ≥ 1.27 mm. Direction of nutrient foramina of all the Femora were directed upwards. Conclusion: This study may help orthopaedic surgeons in planning the surgical treatment of fracture of Femur with a possible reduction in post-operative complications. Combined periosteal and medullary blood supply to the bone cortex helps to explain the success of intramedullary reaming of long bone fractures particularly in the weight bearing Femur.

Study of Nutrient Foramina of Adult Femora With its Correlation to Length of the Bone.

Introduction: Femur is the most richly vascularised long bone which derives its nourishment from various arteries of the lower limb. The quantum of blood supply is determined by the number and calibre of these arteries. Shaft of this bone is supplied by the vessels from perforators of the thigh which gives nutrient branches to it. Femoral shaft fractures are severe disabling injuries that demand critical evaluation as to the method of treatment. Since the success of these operations depends on a minimal interference with the blood supply of the bone, the knowledge of anatomy of the nutrient vessels is of considerable importance. Materials and Methods: The study was conducted on 300 adult femora available in the department of Anatomy. The study was undertaken to collect information on the variations in number, location, size of the nutrient foramina and if correlation exists between the length of femur and number of nutrient foramina. Results: 60% of the bones had double, 39.33% had single and only 0.67% had single nutrient foramina (NF). 52% of them were on medial lip of linea aspera followed by 41%on lateral lip and the rest scattered. 80% of NF was located on upper and middle segments of shaft and very meagre number in lower segment. No correlation was noted between number of NF and length of the bone. Discussion and Conclusions: The findings in the present study are compared and analyzed with previous researchers. The magnitude of care to be imparted while dealing with fractures of femoral shaft is discussed. The detailed knowledge on vascular anatomy of shaft would allow surgeon to preserve them during procedures.

Surgical Experience of the Distal Internal Carotid Artery Aneurysm

Bifucation of the internal carotid artery aneurysms are rare. But they are paticulary difficult to treat surgically because of perforating arteries surrounding and adherent to the aneurysm. In this series, fourteen patients with bifucation of internal carotid artery aneurysms were treated with direct surgery. Tweleve patients of these were treated with clipping, two were treated with coating. 57% of the patients had a good or excellent result and there was a 7% mortality.

THE MACRO-MICROANATOMY OF THE VESSELS OF THE MEDICAL THORACIC FLAP / 解剖学报

It is scanty in reports about the anatomy of the medial thoracic free flap, that which one of the perforating arteries of the internal thoracic artery is the main arterial source of this flap is still in dispute. This investigation was based on dissection of 50 sides of adult cadavers under the operating microscope.Among the perforating arteries of the internal thoracic artery in the upper four intercostal spaces, the second perforating artery presents a higher incidence of occurence, it also possesses a larger caliber and distributing area. So that it would be the first choice as a pedicle artery in the transplantation of the medial thoracic free flap. The next choice is the first perforating artery, because its distributing area is larger than that of the third as well as the fourth arteries.The second intercostal space is the widest among all other spaces. The internal thoarcic artery in this space is located more superficial and stands further apart from the lateral border of the sternum than that in the other three intercostal spaces. All these advantages are in favor for taking the second perforating artery as the pedicle artery of the free flap or even to take the internal thoracic artery of the same segment together with it. If a portion of the second costal cartilage isresected, the first two perforating arteries and their related portion of internal thoracic artery can be involved in the pedicle, and the area of the skin flap will be increased to a large extent.Some of the applied anatomy of the transplantation of the medial thoracic free flap has been discussed.