Anatomical and Morphological Study of Nutrient Foramen in Leg Bones

Introduction: Knowledge of position of nutrient foramina of long bones can be useful in certain surgical procedures. Bone ossification, growth and healing depend on its vascularity. Nutrient artery is the main source of blood supply of bone along with periosteal arteries. The topographical knowledge of these foramina is useful in certain operative procedures, in orthopedics as well as in plastic and reconstructive surgeries.AIM: The present study aims to determine the number and position of nutrient foramen of tibia and fibula and to observe direction and obliquity of nutrient foramina. Subjects and Methods: 100 adult dry bones including 50 tibia and 50 fibula were studied. Nutrient foramina were identified with naked eyes. The obliquity was determined with hypodermic needle. The nutrient foramina location was determined by dividing total bone into segments, the locations were validated by calculating foraminal index. Results: It has been observed that 98% (49) tibia has single nutrient foramina, double nutrient foramiana present in 2%of tibia. Most of the nutrient foramina in tibia are present in upper third i.e 65%(33).Foramina index of tibia is 45.05 with standard deviation of 8.29.In fibula single foramen was observed in 46(92%) and double foramina 2(4) and there is no nutrient foramen in 2(4). In 2 fibulae having double nutrient foramen, proximal foramen was directed downward and distal foramen was directed upwards. In 50%(25) nutrient foramina is present in posterior surface,most of nutrient are in middle third 48(96%).mean foraminal index of fibula is 45.05 with standard deviation of 8.29. Conclusion: Our study has attempted to put together findings from different studies regarding the number and position and obliquity of nutrient foramina of leg bones .The present study will be useful for orthopedic surgeons during procedures like bone grafting and more recently microsurgical vascularised bone transplantation and new graduates to understand the importance of nutrient foramina of long bones.

An Anatomical Study of Superficial Palmar Arch.

Background: The study of superficial palmar arch and its variations has been reported rarely. The purpose of the study is to provide assessment of anatomical variations in the formation of superficial palmar arch in hand. A classic superficial palmar arch is formed by direct communication between the superficial branch of the ulnar artery and superficial branch of radial artery. Materials and Methods: Twenty dissected upper limb specimens, out of which 16 males and 4 females aged between 18 – 75years were obtained from Department of Anatomy, Bangalore Medical College and Research Institute, Bangalore. The vascular pattern of superficial palmar arch was recorded. Results and Discussion: The complete and incomplete formation of the superficial palmar arch was found in 19 and 1 hands respectively. This indicates that the incidences of complete and incomplete formation of superficial palmar arch are 95% and 5% respectively. Conclusion: The findings suggest that the incomplete formation of superficial palmar arch will lead to ischemia or poor nourishment of intrinsic muscles of the hand.

Anatomical variations in the Ansa cervicalis and innervation of infrahyoid muscles.

Background: – Infrahyoid muscles are supplied by the ansa cervicalis. The present study aimed to study the variations in the ansa cervicalis and the innervation of infrahyoid muscles. Methods: The study was conducted on 40 cadaveric hemi-necks. Results: Out of the 40 hemi-necks, high level of ansa cervicalis was observed in 2 hemi-necks, intermediate level of ansa was observed in 35 hemi-necks and low level of ansa was observed in 3 hemi-necks. Additionally, dual ansa with absence of inferior root was seen in 4 hemi-necks, dual ansa with absence of inferior root and inter-communication between C2 and C3 was seen in 2 hemi-necks, common trunk supplying all infrahyoid muscles including superior belly of omohyoid was seen in 2 hemi-necks, nerve to inferior belly of omohyoid from inferior root was seen on 1 side. In one specimen unilaterally, superior belly of omohyoid was innervated by a branch from hypoglossal nerve, two superior roots arising from hypoglossal nerve and the inferior root formed only by C3 was seen in the same specimen. Discussion: The knowledge of the possible variations of ansa in relation to the great vessels of the neck prevents the inadvertent injury to those vessels. Any injury can result to phonation disability in professional voice users. In case of infrahyoid muscles palsy, patients have no serious voice problems in their normal speech but the pitch of their voice and also prosody in their singing are lost dramatically. Conclusion: These variations are of clinical importance for the reconstructive surgeries which involve the infrahyoid muscles.