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Objective:To explore the changes of bone turnover markers and geometric parameters of hip bone in overweight postmenopausal women with metabolic syndrome(MS), as well as the influence of MS components. To analyze the association of these factors with the risk of fracture.Methods:A total of 505 overweight postmenopausal female patients who underwent health check-up in Lianhu Community Service Center, Danyang City, Jiangsu Province from January to December 2017 were selected. According to the MS diagnostic criteria of the International Diabetes Federation(2009), the patients were divided into MS group( n=331)and non-MS group( n=174). Blood samples were collected to determine the level of procollagen type 1 N-terminal propeptide(P1NP)and carboxy-terminal cross-linked telopeptide of type 1 collagen(CTX). Bone mineral density and hip bone geometry parameters were tested with dual-energy X-ray absorptiometry and hip structural analysis software. Results:The incidence of osteoporotic fracture and hip fracture in MS group was significantly higher than that in non-MS group(21.1% vs 13.8%, 4.8% vs 1. 1%, P<0.05). However, the bone mineral density of lumbar vertebra 1-4, femoral neck, and total hip in MS group was significantly higher than that in non-MS group, which remained after adjusting for age( P<0.05), but the difference disappeared after further adjustment for body mass index( P>0.05). The P1NP, CTX, femur strength index(FSI), section modulus(SM), and cross-sectional area(CSA)of MS group were significantly lower than those of non-MS group, the buckling ration(BR)was significantly higher than that in non-MS group, and the differences were still statistically significant after adjusting for age and body mass index( P<0.05). There was no significant difference in bone mineral density of lumbar vertebra 1-4, femoral neck, total hip, P1NP, and CTX between fracture group and non-fracture group in patients with MS. But FSI, SM, cross-sectional moment of inertia(CSMI), and CSA were significantly lower, BR was significantly higher( P<0.05) and femur strength decreased in patients with fracture. Regression analysis showed that high BR was an independent risk factor for fracture risk, while high FSI, SM, CSMI, and CSA were protective factors. Multivariate linear regression analysis showed that wasit circumference, diastolic blood pressure, and fasting plasma glucose were the main MS components affecting bone mineral density, bone turnover indexes, and hip bone geometry parameters. Conclusions:Overweight postmenopausal MS patients had decreased bone turnover rate, femoral strength, and relatively poor bone quality. Hip bone geometry parameters can be used as one of the methods to assess fracture risk in MS patients. Waist circumference, diastolic blood pressure, and fasting blood glucose are the important MS components affecting bone mass and bone quality.
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Introduction: Acetabulum is a cup shaped cavity on the outer surface of the constricted central part of the hip bone, where three components meet and subsequently fuse. In modern world, orthopaedic surgeons and biomedical engineers are trying to make the best possible prosthesis for planning the total hip replacement. Body proportion and absolute dimension vary widely in respect to age, sex and racial groups. While partially due to variability in muscularity and adiposity, such variations are chiefly in skeletal system. Purpose of study: The main intention of this study was to obtain the morphometric data of acetabulum. This data suffices the mechanics of the hip joint so as to plan for suitable prosthesis and various surgical approaches. Material and method: The study was conducted in the department of Anatomy. Hundred hip bones of both sexes were used. In this study we included only healthy adult bones, deformed and eroded bones were excluded from the study. The osteometric parameters such as diameter, depth and capacity of acetabulum, notch width and shape of the anterior acetabular ridge were measured using digital Vernier calipers and measuring jar. The data was analysed statistically using SPSS software. Results: The mean diameter of acetabulum in males was found to be 5.03 cm and in females it was 4.44 cm, whereas on right side it was 4.70 cm and on left side it was 4.77 cm. The mean depth of acetabulum in males was 2.85 cm and in females it was 2.49 cm, whereas on the right side was 2.71 cm and 2.63 cm on the left. The mean notch width of the acetabulum in males was 2.07 cm and in females it was 1.71 cm, whereas on the right side it was 1.92 cm, and 1.85 cm on the left. Total range for the acetabular capacity was 22-30.68 ml. The curved shape anterior acetabular ridge was the most predominant type (39%) and the least type was irregular shaped (15%). Conclusion: The acetabular parameters such as acetabular diameter, depth, capacity and notch width of the acetabulum was greater in males compared to the females. Statistically the comparison was highly significant. Most common anterior acetabular ridge shape is curved type (39%), least was Irregular type (15%). Morphometric data of acetabulum is essential for clinical correlation and it also helps in the detection of disputed sex by Forensic experts. It also helps the orthopaedic surgeons for planning the total hip replacement
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Background: Skeleton is an excellent investigating material in living and non-living population for genetic,anthropological and forensic purposes. Anatomical knowledge of human osteology, in the evaluation of deathmay help to shed light on legal issues such as sex and age determination, parentage and racial identity. Withracial differences, it’s difficult to implement a uniform method for determining sex. Therefore, the need forpresent study was felt. Many bones of skeleton present size related sexual differences, those of the pelvis usuallydisplayed differences in morphology independent of size as the sex hormones influence the reproductive functions.In the present study an attempt has been made to arrive at appropriate metric data, regarding sex determinationof North Indian pelves using indices calculated upon dry hip bones, sacrum & pelvis as a whole.Materials and Methods: The study was conducted on 50 adult pelvis (M: F= 40:10) obtained from GovernmentMedical College, Amritsar. Measurements related to Pelvic Brim Index, Coxal Index, Index I & Index II of GreaterSciatic Notch, Ischiopubic Index, Sacral index, Longitudinal Curvature index & Corporobasal index were taken bystandardized methods, indices were calculated & results were statistically analyzed.Results: Amongst the various indices calculated in present study Coxal Index, Index I & Index II of Greater SciaticNotch, Ischiopubic Index & Sacral index were found to be significantly sexually dimorphic.Conclusions: Since skeletal characteristics vary among populations; therefore the present study provides adatabase for various significant pelvis related indices amongst North Indian population to optimize the accuracyof sex identification
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Background- It is very difficult to determine sex of skeleton when pieces of skeletal bones are exhumed Objectives- Thus our study aims at: 1. Finding accuracy of the previously set criteria for sexing of hip bone. 2. To find the validity of other criteria in sexing of hip bone by which sex of the skeleton can be determined from small portion of hip bone. Methods- 200 hip bones of known sex (100 male and 100 females) were studied from various medical colleges. Results and Interpretation- Unpaired 't' test was found to be highly significant when values of true pelvic height in males and females were compared. Similarly, 'p' value was found significant in comparing mid-pubic width in males and females. Mean of distance from ischial tuberosity to farthest rim of acetabulum in males was found to be more than that of the females. Very significant differences were observed in the mean of pubic length and acetabular diameter in females. The index mentioned by Maclaughline and Bruce in 1985 was calculated in males and females. The index showed a value of 100.226 in males and 126.944 in female. Conclusion- Apart from the previously mentioned criteria in hip bone sexing, the study helped to prove the importance of following criteria in hip bone sexing : 1.True pelvic height 2.Mid-pubic width 3.Distance from ischial tuberosity to farthest rim of acetabulum 4.Index mentioned by Maclaughline and Bruce 5.Distance from anterior superior iliac spine to pubic tubercle 6.Distance from anterior superior iliac to iliopubic eminence.
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Las condiciones locales anatómicas y los factores generales relacionados con el paciente determinan la elección de la prótesis. En general se requieren más implantes para soportar una prótesis total fija. Además, en muchos casos la indicación de una prótesis fija está limitada por la estructura inadecuada de hueso, a menos que se utilicen procedimientos quirúrgicos adicionales tales como los aumentos óseos con procedimiento de injerto. En este caso clínico que presenta una atrofia avanzada de la maxila, se realiza un injerto de cresta iliaca, con el que se obtiene un reborde adecuado para poder colocar implantes dentales y confeccionar una prótesis fija implanto-soportada. Se da un seguimiento con dos años de control postoperatorio
The selection of the denture for a patient are determined from the local conditions anatomical/morphological and general factors related to the patient. In general more implants are requiered for the support of a fixed complete denture. Besides in many cases this fixed denture is limited by an inadequate bone structure, unless aditional surgical procedures such as bone graft for bone augmentation are performed. In the present clinical case with a severe upper jaw atrophy, a bone graft from the hip was done in order to obtain an adequate bone to receive the dental implants and place a fixed implant supported bridge. A follow up of the patient is of two years now.
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Introduction: Sex estimation of skeletal remains is an important issue in both forensics and bioarchaeology. Many mammalian species display sexual dimorphism in the pelvis, where females possess larger dimensions of the obstetric canal than males. This is contrary to the general pattern of body size dimorphism, where males are larger than females. Pelvic dimorphism is often attributed to selection relating to parturition, or as a developmental consequence of secondary sexual differentiation. Current opinion regards the hip bone as the most reliable sex indicator because it is the most dimorphic bone, particularly in adult individuals. Material & Methods: In the present study, an attempt has been made to find the base line data of thirteen parameters pertaining to ilia of 100 hip bones of known sex and side. Variables studied were: Total length of iliac crest, lengths of its ventral & dorsal segments; distance between Anterior Superior Iliac Spine & Iliac Tubercle; Iliac height; Ventral, Sacral, Direct, Lower & Upper iliac heights; Iliac breadth; Lower, Ventral & Sacral iliac breadths, Length of pelvic & sacral parts of Chilotic Line. Results: The results obtained were tabulated, statistically analysed & compared to the earlier literature. It was seen that almost all the parameters except Sacral Iliac Height, Lower Iliac Height & Pelvic parts of Chilotic line were longer in males. Conclusion: To conclude, the morphometry of ilium also constitutes an important mean of sexual dimorphism. However its parameters are longer in males as it does not form a part of birth canal so is independent of sex hormones & is akin to general rule that male bones are larger than female bones.
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Background: Objective of current study was to study the distance between Posterior Inferior Iliac Spine and Ischial Spine (PIIS-IS) of human hip bone for determination of sex. Methods: The study comprised unpaired 149 adult human hip bones of known sex. The posterior inferior iliac spine and ischial spine were identified in all the hip bones and a vernier calliper was used to measure the distance between the PIIS-IS. Results: It was observed that the mean distance of PIIS-IS in males and females were 49.64 mm and 54.35 mm respectively. The standard deviation in males was 5.75 mm and that of females was 5.15 mm. Maximum no. i.e. 78.66% of males & 62.16% comes under the range of distance between 41-55 mm. Conclusion: It was observed that out of 149 hip bones taken for study 75 were of males and 74 were of females. The Mean distance in females was observed to be greater in comparison to males. Statistically calculated T- test reveals that the parameter taken for study is very highly significant in terms of sex differentiation.
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Introduction: Th e pelvis is most sexually dimorphic and is the fi rst bone assessed in sex determination because it is the skeletal element most aff ected by reproduction and parturition.1 Th e assessment of the pelvis is made through metric measurements as well as through the visual analysis of non-metric traits; both important aspects of the analysis. Th e best methods for determining sex from adult skeletal remains involve measurement and inspection of the hip bone that presents a number of gender-related anatomical diff erences.2 Most osteologists visually (stereoscopic) evaluate these diff erences and integrate this subjective assessment ofhip bonemorphology into their sex determinations. Th e aim of thepresent study is to visually evaluate sexual diff erences in hip bone and comparing its effi cacy with metric assessment. Methods: Th is study is done on 46 hip bones of adult individuals of known sex from museum of department of anatomy of SGRRIM&HS Dehradun and TMMC&RC Moradabad, India. All these hip bones were visually examined and under mentioned fi ve characters of the hip bone were used, (A) aspects of the preauricular surface, (B) aspects of the greater sciatic notch, (C) the form of the composite arch, (D) the morphology of the inferior pelvis, and (E) ischiopubic proportions. Results: In this study traits of the group (A) were most sexually dimorphic while traits of the group (E) were least sexually dimorphic. Conclusion: Diagnostic accuracy is excellent when the complete hip bone is available. Hip bone features used for sex determination by visual assessment seem to be fairly stable.
Sujets)
Adulte , Endoscopie/méthodes , Femelle , Humains , Mâle , Os coxal/anatomie et histologie , Os coxal/analyse , Caractère quantitatif héréditaire , Caractères sexuels/étiologieRésumé
Background: The distinctive biometry of the anterior border of the human skeleton and its clear sexual dimorphism make it of interests from anatomical, forensic, obstetrical, radiological, archaeological and anthropological point of view for examination of skeleton remains. Aims & Objective: To determine the sex of human being from the anterior border of the hip bone. Material and Methods: For the present study total 306 normal dry human hip bones, out of which 202 are of male and 104 are of female, 141 are of Right side, 165 of Left side were studied. Osteometric board with graph paper and Sliding Vernier Calliper are used for all measurement. Results: Statistically highly significant(P ≤ 0.001) differences were detected between means in relation to sex for 6 variables ( The maximal width of the anterior border notch, The distance from the anterior superior iliac spine to the pubic tubercle , The distance from the anterior inferior iliac spine to the iliopubic eminence , The distance from the anterior inferior iliac spine to the pubic tubercle , The length of the notch between the anterior inferior iliac spine and the iliopubic eminence, The depth of the notch between the anterior inferior iliac spine and the iliopubic eminence), Statistically very significant differences(p≤0.005) were detected between means in relation to sex for 2 variables( Index of widening of the anterior interspinous notch, The depth of the anterior interspinous notch), Statistically significant differences(P≤.01) were detected between means in relation to sex for 1 variable (Index of widening of the notch between the anterior inferior iliac spine and the iliopubic eminence). These variables could be used for sex determination from the human hip bone or its fragments. Conclusion: Therefore we consider that these 6 variables are the best of the variables studied for sexing human hip bone (P < 0.001).
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The aim of this study was to produce a simple and inexpensive technique for estimating the obturator foramen area (OFA) from young calves based on the hypothesis that OFA can be extrapolated from simple linear measurements. Three linear measurements - dorsoventral height, craneocaudal width and total perimeter of obturator foramen - were obtained from 55 bovine hemicoxae. Different algorithms for determining OFA were then produced with a regression analysis (curve fitting) and statistical analysis software. The most simple equation was OFA (mm2) = [3,150.538 + (36.111*CW)] - [147,856.033/DH] (where CW = craneocaudal width and DH = dorsoventral height, both in mm), representing a good nonlinear model with a standard deviation of error for the estimate of 232.44 and a coefficient of multiple determination of 0.846. This formula may be helpful as a repeatable and easily performed estimation of the obturator foramen area in young bovines. The area of the obturator foramen magnum can thus be estimated using this regression formula.
Sujets)
Biométrie , Foramen magnum , Dynamique non linéaire , OstéologieRésumé
The distinctive morphology of human skeleton and its clear sexual dimorphism make it of interests from anatomical, forensic, obstetrical, radiological and anthropological point of view. 100 known sex normal dry human hip bones obtained from Medical College Bhavnagar, 168 known sex normal dry human hip bones from BJ Medical College, Ahmedabad and Smt. NHL Municipal Medical College, Ahmedabad were studied the year of 2005-06. The posterior segment of Greater Sciatic Notch, Genoves’ sciatic notch index and posterior angle are found to be significant by t test (P < 0.001). The posterior angle of greater sciatic notch was found to be highly significant for determination of sex of hip bone.
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The sex determination of individual is greatly useful in Anatomy, Archeology & Forensic departments. The hip bone is most reliable bone to determine the sex of individual. A biometrical study of posterior border of 100 adult human hip bones has been done. With the use of osteometric board & triflanged stainless steel caliper, various parameters were measure. Various variables of posterior border of hip bone were calculated by using range, mean, S.D. & P value. In all parameter the arch PB (arch of posterior border), the total angle of greater sciatic notch & the posterior angle of greater sciatic notch gives statistically significant differences between the means related to sex. Above three parameters were highly significant to determine the sex by posterior border of hip bone. The mean value of the arch PB of male was high than female. The mean value of posterior angle of greater sciatic notch was 2.5 times higher in female. We had also measure demarking point (DP) for above three variables. The demarking point gives 99.75% accurate data which were measure by adding & subtracting 3xS.D.from the means. In present study the demarking point for arch PB was >143mm in male & <126mm in female, total angle of greater sciatic notch was <460 in male & >860 in female & posterior angle of greater sciatic notch <110 in male & >250 in female. In medicolegal cases where 100% accuracy is required, the use of demarking point is preferable. This study is useful for carrying out medico legal examination of bones, cephalopelvic proportions in obstetric cases, for academic studies in Anatomy & for anthropological examination of skeleton, radiological study of pelvis & for archaeological examination of skeleton.
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Crista phallica (CP) is used to determine sex in anthropology and criminal forensic medicine; however, it does not exist in anatomic and radiological terminology. The purpose of this retrospective study is morphometric analysis of the CP. We studied radiographs displaying several different clinical indications from patients whose bone maturation were fully complete. The crista phallica located on both sides of the medial portion of ischiopubic ramus (IPR) were localized and their peak points were determined. The distance from these peak points to the inner cortex of IPRs were measured, as well as the angles between the tangents passing the peak points from both sides. We determined the distance of the IPR (DIPR) for males and females sequentially as 21.3 +/- 3.5 mm, and 17 +/-2.8 mm, angle of CP (ACP) as 149.1 +/-15.7, and 163.5 +/-13.4. It was identified that ACP for females is less than ACP for males (p<0.001). ACP and DIPR alone are not sufficient criteria to determine sex. Therefore, the results of our findings show that it would be more useful to study other specifications and their metric analysis in order to determine sex.
La cresta fálica (Crista phallica, CP) se utiliza para determinación de sexo en antropología y la medicina forense, sin embargo, no existe en la terminología anatómica y radiológica. El objetivo de este estudio retrospectivo es el análisis morfométrico de la CP. Estudiamos radiografías que muestran varias indicaciones clínicas diferentes de pacientes cuya maduración ósea fue totalmente completa. La cresta fálica se situó a ambos lados de la porción medial de la rama isquio-pubiana (RIP), donde su localización y sus puntos más altos fueron determinados. La distancia desde estos puntos más altos a la corteza interna de la RIP fueron medidos, así como los ángulos entre las tangentes que pasaron por los puntos más altos de ambos lados. Se determinó la distancia de la RIP (DRIP) para hombres y mujeres de forma secuencial como 21,3 +/- 3,5 mm, y 17 +/- 2,8 mm, ángulo de la CP (ACP) como 149,1 +/- 15,7 y 163,5 +/- 13,4. Se identificó que los ACP para mujeres fueron menores que las ACP para los hombres (p <0,001). ACP y DRIP por sí solas no son criterios suficientes para determinar el sexo. Por lo tanto, los resultados de nuestros hallazgos muestran que sería más útil para estudiar otras especificaciones y sus análisis métricos a fin de determinar el sexo.