Topography and morphological anatomy of nutrient foramina in human metacarpal bones and their clinical implications.

PURPOSE: To study the morphological and topographic anatomy of nutrient foramina and to determine the foraminal index of metacarpal bones. MATERIALS AND METHODS: The study consisted of 438 unpaired, human metacarpal bones of unknown age and sex. Nutrient foramina in each of the bones were grossly identified in relation to their number and location. The foraminal index was calculated by applying the Hughes formula. A digital vernier caliper was used to perform the measurements. RESULTS: Among our specimens, 93.1% of metacarpals had single foramen, 2% had double foramina, 0.3% of the bones had triple foramina and in 4.6% of cases the foramen was absent. The mean foraminal indexes of the 1st, 2nd, 3rd, 4th and 5th metacarpal were 60.1, 53, 43.1, 43.7 and 45.9 respectively. CONCLUSION: It was observed that the morphology and topography of nutrient foramina vary among different metacarpals. In 1st and 2nd metacarpals, foramina were more common at the medial surface and in other metacarpals, mostly seen on the lateral surface. The knowledge about these foramina is important in certain surgical procedures to preserve the circulation. This data is important to the plastic surgeon for microvascular bone transfer surgeries.

Bone morphometry.

OBJECTIVES: To compare anatomical measurements with that of radiological measurements. BACKGROUND: The radiological measurements are commonly used in clinical practice. It is well known that the anatomical measurements are more accurate than radiological. The comparison of anatomicoradiological measurements is not reported hitherto. METHODS: One human adult cadaveric femur bone was used for the present study. It was measured both anatomically and radiologically. RESULTS: In digital X- ray measurements, the length from the upper lip of fovea capitis to the most prominent part of greater trochanter was 87.2 mms, from the upper most part of greater trochanter to the isthmus it was 147.9 mms, mediolateral width of medullary cavity at the isthmus was 8.9 mms, the mediolateral width at the distal root of lesser trochanter was 18.5 mms, anteroposterior width of medullary cavity at the isthmus was 11.5 mms, the anteroposterior width at the distal root of lesser trochanter was 16.8 mms. The same measurements were 91.2 mms, 154.6 mms, 11.8 mms, 19.7 mms, 11.9 mms and 18.5 mms when taken anatomically using the digital vernier caliper. CONCLUSION: The present study showed that in all the parameters measured the radiological values were slightly lesser than the anatomical values. Considering the variations in the values, the implants can be designed for a particular case in orthopedic surgery. We believe that this study adds an important reference in the scientific literature (Tab. 1, Fig. 2, Ref. 5).

Peroneus quartus, an accessory muscle in human: case report and its clinical importance.

The peroneus quartus is an accessory peroneal muscle seen in man. The term 'peroneus quartus' is often used to refer one or several of the accessory peroneal muscles. In this case, we report an unusual type of peroneus quartus which was originating from the muscular portion of the peroneus brevis and inserting onto the peroneus longus tendon. The clinical implications are emphasized with the morphological significance and literature review. The orthopedic surgeons and radiologists should be aware of the possible presence of this muscle not only because of its associated pathology, but also for its potential use in plastic surgeries.

Morphological study of lingula of the mandibles in South Indian population.

PURPOSE OF THE STUDY: The objectives were to study the morphology of the lingulae in adult human dried mandibles of South Indian population. MATERIALS AND METHODS: The study was carried out on 67 (37 males and 30 females) dry mandibles and the morphological variants of the shapes of the lingulae were macroscopically noted and classified. Totally, 134 lingula were studied from both sides of mandibles. RESULTS: From our observations, 29.9% (40) of the lingula had triangular shape, 27.6% (37) were truncated, 29.9% (40) were found nodular and 12.6% (17) were assimilated. In 61.2% (41) of the mandibles, the shape of the lingula was symmetrical on both the sides. The triangular lingulae were found bilaterally in 14, truncated in 11, nodular in 10 and assimilated in six mandibles. CONCLUSION: In our specimens, the majority of the mandibles were having triangular shaped lingula and the shape of the lingula was symmetrical on both sides. There was sexual dimorphism observed, as in males the triangular shape was more common and in females it was nodular. The incidence of different forms of lingulæ can be used as an anthropological marker to assess the different group of population and races, with other non-metric variants of the skull. The morphology of this subject is important to the maxillofacial and orodental surgeons as the inferior alveolar nerve is close to the lingula and may assist in the inferior alveolar block.

Vertebral body integrity: a review of various anatomical factors involved in the lumbar region.

UNLABELLED: The body of the vertebra can be affected in the majority of the conditions involving the lumbar spine. Multiple references, both books and periodicals, have been reviewed, and the anatomical factors responsible for the vertebral body integrity in the lumbar spine have been included under the following important areas, namely, morphology, development, genetics, microscopic examination using histology, structural architecture, blood supply, neuromuscular control, and biomechanics. INTRODUCTION: The anatomy provides a three-dimensional frame work to support the interaction between the physiological and pathological alterations. The body of the vertebra can be affected in a majority of acute or chronic conditions involving the lumbar spine. The etiology of these conditions is multifactorial, which has been dealt with in previous studies sporadically. This study aims to review and incorporate the important anatomical factors which can influence the integrity of vertebral bodies in the lumbar region and manifest as low back pain. METHODS: Multiple references, both books and periodicals, have been reviewed for the literature. Electronic databases, including Medline and PubMed, were used to collect the latest information. They were finally arranged in an anatomical framework for the article. An attempt has been made to cover these relevant issues in an integrated way in the article and have been structured into introduction, morphology, development, genetics, microscopic examination using histology, structural architecture, blood supply, neuromuscular control, biomechanics, and conclusion. The aforementioned anatomical aspects, some of which have received less attention in the literature, may be helpful to clinicians for restoring the mobility, stability, and load bearing capacity of the lumbar spine as well as planning better management strategies, especially for the chronic low back pain. RESULTS: In our article all the anatomical factors affecting the integrity of vertebral body, including the morphology, development, genetics, growth and ossification, blood supply, specifically in the lumbar region, have been described, which were not covered earlier. The limitations of this review is its wide dimensions; hence, there are fair scopes of missing many relevant facts, as all of them cannot be compiled in a single article. We have attempted to confine our views to different anatomical domains only, this is our second limitation. Additional studies are required to incorporate and discuss the uncovered relevant scientific details. CONCLUSIONS: The integrity of the body of the lumbar vertebra is multifactorial (Fig. 8). The vast spectrum of the anatomical domain influencing it has been summarized. The evolution of erect posture is a landmark in the morphology of human beings and the lumbar lordosis, which has also contributed to the gross design of the vertebral body, is one of the most important adaptations for axial loading and bipedal movements. The role of metamerism in the evolution of vertebrate morphology is repeated in the development of spine. The body of the vertebra is intersegmental in origin, which results in dual vascular and nerve supply, both from superior and inferior aspects of the body of the lumbar vertebrae. The vertebral body ossifies from three primary centers, one for centrum, which will form the major portion of body, and the other two for neural arches. The cartilaginous growth plate is mainly responsible for the longitudinal vertebral growth. Regional differentiation of the vertebral column, and the definite pattern of the structure of the different vertebra, is regulated by a large number of genetic factors, including the Hox genes. The vertebral body design therefore provides the requirements for optimal load transfer by maximal strength with minimal weight. Bone mineral density (BMD), bone quality, microarchitecture, and material properties are the important factors that contribute to bone strength. BMD is highly heritable; bone mineral distribution and architecture are also shown to be under strong genetic influence. All the aforementioned factors finally integrate to ensure mainly the mobility, stability, and load bearing capacity of the lumbar spine.