Anatomical Diversity in Femur bones: Understanding the Morphological Variability for Surgical and Prosthetic Applications / Diversidad Anatómica en Huesos Fémur: Comprensión de la Variabilidad Morfológica para Aplicaciones Quirúrgicas y Protésicas

SUMMARY: The femur, the body's longest bone, plays a critical role in orthopaedics and radiology. Understanding its anatomy, particularly the neck-shaft angle (NSA), is vital for diagnosing bone issues and designing hip implants. While some Asian populations' femur measurements have been studied, there is a research gap concerning Sri Lankans. This study aimed to fill this gap by examining the proximal femur's anatomy in the Sri Lankan population. We analysed 45 adult human femurs (26 right, 19 left) of unknown sex, ethically sourced from the University of Sri Jayewardenepura. Femurs with fractures or pathologies were excluded. Precise measurements were recorded using digital vernier callipers, with millimetre accuracy. Parameters included mean femoral length, vertical and transverse femoral head diameters, neck axis and neck length. Each measurement was taken three times to minimize subjectivity. Right femurs had a mean length of 42.8 mm (SD±2.64), while left femurs measured 43.53 mm (SD±3.27). Mean NSA was 125.78º (SD±4.45) for left femurs and 127.59º (SD±2.06) for right. Mean femoral head diameters were 4.09mm (SD±0.30) (right) and 4.12mm (SD±0.31) (left). Mean anterior neck lengths of the right and left were 2.61 (SD±0.54) and 2.71(SD±0.50) respectively. Comparing our findings with other Asian populations highlighted significant variations in femur measurements. These discrepancies emphasize the need for population-specific data for orthopaedic interventions and raise questions about the suitability of imported prosthetics. Differences in femur length, neck length, and NSA between sides suggest potential challenges in using implants designed for one side on the other. This study underscores the necessity of population-specific data in orthopaedics, as femur measurements differ even among Asian populations. Further research and statistical analysis are essential for tailoring orthopaedic solutions to individual populations. The findings also suggest a potential need for locally manufactured prosthetics to better suit the Sri Lankan population.

El fémur, el hueso más largo del cuerpo, desempeña un papel fundamental en ortopedia y radiología. Comprender su anatomía, en particular el ángulo cuello-diáfisis (NSA), es vital para diagnosticar problemas óseos y diseñar implantes de cadera. Si bien se han estudiado las medidas del fémur de algunas poblaciones asiáticas, existe un vacío en la investigación sobre los habitantes de Sri Lanka. Este estudio tuvo como objetivo examinar la anatomía del fémur proximal en la población de Sri Lanka. Analizamos 45 fémures humanos adultos (26 derechos, 19 izquierdos) de sexo desconocido, obtenidos éticamente de la Universidad de Sri Jayewardenepura. Se excluyeron fémures con fracturas o patologías. Se registraron mediciones precisas utilizando calibradores vernier digitales, con precisión milimétrica. Los parámetros incluyeron la longitud femoral media, los diámetros vertical y transversal de la cabeza femoral, el eje del cuello y la longitud del cuello. Cada medición se tomó tres veces para minimizar la subjetividad. Los fémures derechos tuvieron una longitud media de 42,8 mm (DE ± 2,64), mientras que los fémures izquierdos midieron 43,53 mm (DE ± 3,27). La NSA media fue de 125,78º (DE±4,45) para el fémur izquierdo y de 127,59º (DE±2,06) para el derecho. Los diámetros medios de la cabeza femoral fueron 4,09 mm (DE ± 0,30) (derecha) y 4,12 mm (DE ± 0,31) (izquierda). Las longitudes medias del cuello anterior de la derecha y la izquierda fueron 2,61 (DE ± 0,54) y 2,71 (DE ± 0,50) respectivamente. La comparación de nuestros hallazgos con otras poblaciones asiáticas destacó variaciones significativas en las medidas del fémur. Estas discrepancias enfatizan la necesidad de datos específicos de la población para las intervenciones ortopédicas y plantean dudas sobre la idoneidad de las prótesis importadas. Las diferencias en la longitud del fémur, la longitud del cuello y la NSA entre lados sugieren posibles desafíos al utilizar implantes diseñados para un lado en el otro. Este estudio subraya la necesidad de datos específicos de la población en ortopedia, ya que las mediciones del fémur difieren incluso entre las poblaciones asiáticas. Es esencial realizar más investigaciones y análisis estadísticos para adaptar las soluciones ortopédicas a poblaciones individuales. Los hallazgos también sugieren una posible necesidad de prótesis fabricadas localmente para adaptarse mejor a la población de Sri Lanka.

Anatomical Study Of Inferior Thyroid Artery And The Variation In The Relationship Between Recurrent Laryngeal Nerve And Inferior Thyroid Artery In Sri Lankan Population

Introduction: Terminal branches of inferior thyroid artery (ITA) supplies thyroid and parathyroids. Recurrentlaryngeal nerve (RLN) is related to ITA at lower pole of thyroid and RLN may lie either posterior, anterior orintermingled with terminal branches of ITA. RLN is a vulnerable structure that gets damaged during thyroidsurgeries.Aim: Present study aims to determine variation in relationship between ITA and RLN, entering pattern of ITA intothyroid and number of terminal branches of ITA in Sri Lankan population.Materials and methods: A total of 312 sides (Male:204, Female:108) of thyroid together with intact neurovascularstructures were selected for study of relationship, entrance pattern and number of terminal branches of ITA. TheRLN may lie either posterior (Type A) or anterior (Type B) to ITA or its branches. Sometimes RLN may interminglewith terminal branches of ITA (Type C).Results: A total sample of 65.2% in male (M) and 60.9% in female (F) were Type A, samples of 10.35%(M) and22.22%(F) were Type B and 24.5%(M) and 17.59%(F) were type C. Type A was more predominant in left side of bothgenders and in the right side there are 50% of chances for Type A in both genders. Comparatively Type B was morein female and Type C was more in male. A total of 63.7%(M) and 69.44%(F) ITA entered into middle 1/3rd, 36.27%(M)and 30.55%(F) into lower 1/3rd of the thyroid lobe and entering pattern was more or less similar in both genders.ITA commonly entered thyroid just above junction of middle and lower third of thyroid lobe. ITA divided into twobranches in 52.45%9(M) and 56.48%(F), three in 44.6%(M) and 41.66%(F) and four in 2.94%(M) and 1.85%(F) ofstudied samples.Conclusions: Knowledge of anatomical variation of ITA and RLN is mandatory to avoid injury to RLN in thyroidsurgeries. Understanding the entrance pattern and terminal branches of ITA are essential for thyroid andparathyroid surgeries