Chandni Gupta

Non-metrical study of the pattern of talar articular facets in south Indian dry calcanei

ObjectiveTarsal coalitions are common in the middle talocalcaneal joints and prognosis of intracapsular fractures in the region is bad. So this study was done to know the size, shape and number of talar articular facets and the distance between the two anterior facets.Materials and methodsA total of 300 (154 right and146 left) dry human calcanei of unknown sex were studied. The articular facets were marked with marker pen; the distance between the smaller anterior and middle facets was measured using a vernier calipers and they are classified into four types.ResultsAfter classification of the calcanei, we found that Type-1 was 67%, Type-2 was 28.66%, Type-3 was 3%, and Type-4 was 1.33%.ConclusionIn our study, Type-1 was common followed by Type-2. Race appears to play a part in the determination of the type of facets and hence this study will be useful for the orthopedics surgeons during various surgical procedures.

A morphological and morphometric study of placenta with its clinical implications

Objective: In the idiopathic intrauterine growth restriction where there are no clear maternal or fetal causes, the placenta may hold the key to its etiology. So, this study was undertaken to look for any placental and umbilical cord abnormality and to establish the relationship of fetal birth weight with placental measurements. Materials and Methods: In this study, 100 freshly delivered placentae were collected. The placenta and the umbilical cord were examined to look for any abnormalities in the shape, cord insertion, and vessels in the cord; placenta weight, its circumference, diameter, volume, and thickness at the level of cord insertion were also noted. Baby′s weight at birth and age in weeks, maternal history about diabetes and hypertension were also noted down. IBM SPSS Statistics for Windows version 20.0, USA was used to do statistical analysis of the measurements. Results: In the present study, placenta weight, volume, diameter, and circumference show a strong correlation with fetal weight. We found placenta of round and abnormal shapes in 89% and 11% of cases, respectively. In 76% of cases, we got normal cord insertion and in 24% of cases, abnormal cord insertion. Statistical analysis of all the parameters of the placenta was done. Conclusion: In our study, placenta weight, volume, diameter, and circumference showed a strong correlation with fetal weight. The knowledge of these measurements on the placenta and umbilical cord will be helpful to the pediatrician and obstetrician in clinical practice.

Anatomic study of the occipital condyle and its surgical implications in transcondylar approach

Background: Craniovertebral surgeries require the anatomical knowledge of craniovertebral junction. The human occipital condyle (OC) is unique bony structure connecting the cranium and the vertebral column. A lateral approach like transcondylar approach (TA) requires understanding of the relationships between the OC, jugular tubercle, and hypoglossal canal. Hence, the aim of the present study was to analyze the morphological variations in OCs of dry adult human skull. Materials and Methods: The study was carried out on 142 OC of 71 adult human dry skulls (55 males and 16 females). Morphometric parameters such as length, width, thickness, intercondylar distances, and the distances from the OC to the foramen magnum, hypoglossal canal and jugular foramen were measured. In addition, the different locations of the hypoglossal canal orifices in relation to the OC and different shapes of the OC were also noted. Results: The average length, width and height of the OC were found to be 2.2, 1.1 and 0.9 cm. The anterior and posterior intercondylar distances were 2.1 and 3.9 cm, respectively. Maximum and minimum bicondylar distances were 4.5 and 2.6 cm, respectively. The intra-cranial orifice of the hypoglossal canal was found to be present in middle 1/3rd in all skulls (100%), and extra-cranial orifice of the hypoglossal canal was found to be in anterior 1/3rd (98%) in relation to OC. The oval shaped OC (22.5%) was the most predominant type of OC observed in these skulls. Conclusion: Occipital condyle is likely to have variations with respect to shape, length, width and its orientation. Therefore, knowledge of the variations in OC along with careful radiological analysis may help in safe TAs during skull base surgery.

A study of morphometric evaluation of the maxillary sinuses in normal subjects using computer tomography images

Objectives: The paranasal sinuses are complex anatomical structures with a significant inter-individual variation. The dimensions of maxillary sinuses are particularly significant when considering endoscopic sinus surgery . The aims of this study were to estimate different dimensions of the maxillary sinuses measured on head CT, and their relations to sex of the individuals. Materials and Methods: Cranial computerized tomographic images (CT) of 200 normal subjects between the age groups of 18 and 80 years were observed in this study. The height, width, and depth of the maxillary sinuses were measured with a Philips Brilliance 64 CT. The statistical analysis for sex and age comparison for all the parameters was done. Results: The mean width, height, and depth of maxillary sinus in male on both right and left side were 27.8, 28.2, 39.9, 39.6, and 40.0, 39.7 mm but in females were 26.6, 26.7, 36.8, 37.1, and 36.6, 37.4 mm. The discriminative analysis showed that the accuracy of maxillary sinus measurements i.e. the ability of the maxillary sinus size to identify gender was 55% in females and 69.5% in males. Conclusion: This study on CT dimensions of maxillary sinuses may be beneficial for the ENT surgeons when planning for endoscopic sinus surgery and to support gender determination.

A morphological and morphometric study of proximal and distal ends of dry radii with its clinical implications.

Background: Knowledge of the size and shape of radial head is essential for construction of radial head prosthesis. Further, the measurements of bicipital tuberosity and its angular relationship to radial head are significant in surgical techniques, like in the reconstruction of biceps tendon. Even the morphometry of the distal radius is significant in numerous clinical orthopedic situations such as reduction of distal radius fractures and in the design of distal radius prosthesis. So, the aim of the study was to determine the morphometric parameters of proximal and distal radius in dry adult Indian radius. Methods: Fifty intact adult Indian radius (right = 23, left = 27) were chosen, and the various parameters of proximal and distal ends of radius were studied. Student′s t-test was done to correlate all these parameters on the right and left sides. Results: The mean length of radius, height of head at medial and lateral ends, head anteroposterior and transverse diameter, head thickness at ventral, dorsal, and lateral ends were 23.5, 0.90, 0.75, 1.91, 1.85, 0.42, 0.32, and 0.30 cm, respectively. The mean depth of articular facet, length of neck, proximal and distal neck diameter, width and length of bicipital tuberosity, and radial circumference at bicipital tuberosity were 0.19, 1.19, 1.36, 1.31, 1.23, 1.97, and 4.54 cm, respectively. The mean length of styloid process, oblique and transverse width of lower end, anteroposterior diameter of lower end, and angle of radial inclination were 0.98cm, 2. 81cm, 2.59cm, 1.86cm, and 25.05°, respectively. Conclusion: This study will be useful for orthopedic surgeons in making prosthesis for the proximal and distal ends of radius.

A morphological and morphometric study of jugular foramen in dry skulls with its clinical implications

Objective: Jugular foramen of human skull is one of the most interesting foramina. It is a complex bony canal, numerous vital structures, including nerves and vessels are transmitted through it. Most of the intracranial and extra cranial lesions of posterior cranial fossa might affect the structures in jugular foramen in addition to intrinsic abnormalities. As the neurosurgeons have become courageous in approaching this area, so there is a need to become familiar with this area. Hence, the present study was done to examine the anatomy of jugular foramen, including its morphological features and dimensions. Materials and Methods: The study was carried out on 50 dried skulls. 100 jugular foramina were studied on both right and left side of skulls. The length, width of jugular foramen and width and depth of jugular fossa were measured using vernier calipers. Presence of dome, complete and incomplete septation was also looked for. Results: The mean right and left anteroposterior diameter, latero-medial diameter, area, jugular fossa width, depth in our study was 11.22, 16.52, 187.34, 6.83, 11.58 mm and 9.52, 16.02, 153.2, 5.69, 11.13 mm. Dome was present in jugular foramen in 74% on the right side and 58% on the left side. Complete septation in jugular foramen is seen in 44% on the right side and 42% on the left side. Conclusion: This study will help the neurosurgeons while doing surgery in this region.

A morphometric study of acromion process of scapula and its clinical significance

Objective: The acromion process is associated with a variety of ailments in the shoulder. Therefore, the aim of this study was to record and study all the morphometric values of the acromion process and its morphological features. Materials and Methods: The study was carried out on 50 unpaired dried scapulae. The length, width, and thickness of the acromion process were measured, and the length and width of scapula was also measured using vernier calipers. The acromiocoracoid and acromioglenoid distances were also measured. The shape, type of acromion process, and the presence of enthesophytes were noted and whether the anterior 2/3 rd of inferior surface of acromion process is rough or smooth was also noted. Results: The mean length, width, and thickness of acromion process were 4.21, 2.42, and 0.73 cm, respectively. The mean length and width of scapula were 13.93 and 10.14 cm, respectively. The mean acromiocoracoid distance and acromioglenoid distance were 3.09 and 2.47 cm, respectively. The most common shape of the acromion process noted was quadrangular in 40% of scapulae. In 90% of scapulae, the anterior 2/3 rd of inferior surface was rough and in 80% scapulae, enthesophytes were present. Conclusions: This study will help the clinicians in understanding and curing various shoulder joint disorders.

A morphological study to note the variable patterns of cutaneous innervation on the dorsum of foot in south Indian human foetuses and its clinical implications.

Background: Cutaneous nerves on the dorsum of foot are at risk for iatrogenic damage while performing arthroscopy, local anaesthetic block, surgical approach to the fibula, open reduction and internal fixation of lateral malleolar fractures, application of external fixators, elevation of a fasciocutaneous or fibular flaps for grafting, surgical decompression of neurovascular structures, or miscellaneous surgery on leg, foot and ankle. Hence the present study was undertaken to classify the different patterns of cutaneous innervation on the dorsum of foot of foetuses which will help in minimizing iatrogenic damage to the nerves. Materials and Methods: A total of 40 lower limbs from 20 foetuses were dissected and the branching patterns of nerves were noted and specimens were photographed. Results: Four distinct patterns of innervation with additional subtypes were identified and designated as Type 1 a-g; 2 a-d; 3; 4 a-c. Conclusion: Detailed knowledge about the pattern of cutaneous innervation of dorsum of foot may decrease the damage to these nerves during operative procedures near the foot and ankle.

A Morphometric Study of Incisura Fibularis in South Indian Population with its Clinical Implications

Backgroud: The distal tibiofibular joint is formed by the medial convex surface of the distal end of the fibula and the lateral concave surface of the fibular incisura of the tibia. The bond between the tibia and the fibula at the level of the ankle is of utmost significance for the appropriate functioning of the distal tibiofibular joint. So, this study was done to measure various dimensions of fibular incisura of tibia and width of distal end of fibula. Materials and Method: 47 adult fully ossified dry tibias and 37 fibulae were taken for the study. Various measurements of fibular incisura of tibiae and width of distal end of fibulae were measured using vernier caliper.Results: The total (right + left) mean values of the width and depth of the incisura fibularis of tibia was 2.33 and 1.08cm.The total mean values of the length of anterior and posterior facet of incisura fibularis of tibia was 1.34 and 1.28cm. The total mean width of distal end of fibula was 2.44cm. Conclusion: The results of this study will be useful for biomedical peoples who make implants of lower end of tibia and fibula for orthopaedic surgeons during ankle reconstruction surgeries.

A morphometric study of arch of the great saphenous vein and its clinical significance

Objective: Varicosities in the lower limbs are the most important afflictions of the venous system, as well as of the peripheral vascular disorders. They are always caused by a fault in the valves inside the veins at the point where the superficial veins communicate with the deep veins. If the valve leaks, the blood flows backwards and this increases the pressure in the superficial veins, which, as blood stagnates, becomes swollen and varicose. The treatment of these varicose veins is surgery, for which the surgeons should have a sound knowledge of the anatomy of the great saphenous vein (GSV). So, the aim of our study was to establish palpable anatomical markers for its exploration and surgical approach. Materials and Methods: In this study, 25 inguinofemoral regions of lower limbs were dissected. After exposing the arch of the GSV, we took the following measurements using a calliper - the distance separating the top of the arch of the GSV a) from the ventral-cranial iliac spine, b) from the pubic tubercle, and c) from the inguinal ligament. Statistical analysis of the measurements was done. Results: The mean distance of the arch of the GSV from the ventral cranial iliac spine, pubic tubercle, and the inguinal ligament was 9.46 cm, 4.66 cm, and 2.75 cm respectively. In addition, we found in one case a duplication of the GSV just above the knee. Conclusion: These measurements will help the surgeons in identifying the arch of the GSV before it opens into the anterior-internal surface of the femoral vein.