RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA, BANGALORE
PROFORMA
FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
ANNEXURE - I
6.1 NEED FOR STUDY
The knowledge of nutrient foramen is important in surgical procedures like Bone Grafting, Fracture Treatment, Nailing of long bone in fractures particularly weight bearing like femur and tibia. Recently the importance of nutrient foramen in micro surgical vascularised bone transplantation.
ANNEXURE - II
6.2 REVIEW OF LITERATURE
The nutrient artery is a principal source of blood to along bone and is particularly important during its active growth period.
Berard¹ in 1835 was the first to correlate the direction of nutrient canal with the mode of ossification and growth of the bone.
Wood Jones¹¹ 1946 according to him the nutrient foramina of the 1st, 2nd, 3rd and 4th metatarsals are located on their lateral surface. Whereas the 5th on the medial surface. This pattern is reversible in metacarpals.
Hughes3 1952 has stated that anomalous canals are common in femur, rare in radius and very rare in other bones.
Singh⁹ in 1959 observed the absence of nutrient foramine were common in 1s3t metacarpal and double foramine frequently seen in 2ndand 3rd metacarpals.
Clark⁵ in 1965 stated that greater longitudinal growth at the growing end of the bone resulted in deflection of the nutrient artery. so that its entrance which is initially at right angles to the shaft becomes oblique. The obliquity being directed towards the non-growing end of the bone.
Patake and Mysorekar⁶ 1977 found that the absence of nutrient foramine was common in 1st metatacarpals. Double foramine are common in 1st, 2nd and 5th Metacarpals
Srimankar and Trivedi⁸ 2010 observed the position of nutrient foramen of the
1st metacarpal in the distal third. Other metacarpals 2nd, 3rd, 4th and 5th in the middle third. Position of the nutrient foramine of 1st and 2nd metacarpals were on the medial surface.3rd, 4th, and 5th, metacarpals on the lateral surface.
Direction of the nutrient foramen is always away from the growing end. Position of the foramen is nearer to the growing end.
Ojaswini Malukar and Hemang Joshi⁷ observed the nutrient canal through which the nutrient artery enters the shaft typically becomes slanted during growth. The direction of slant from surface to marrow cavity points towards the end that has grown least rapily. This is due to greater longitudinal growth at the faster growing end. The importance of nutrient faramen is relevant to fractured treatment, nailing of long bone fracture particularly weight bearing like femur and tibia, and uses of vascularised fibula bone in bony defects due to trauma.
ANNEXURE – III
6.3 OBJECTIVES OF STUDY
To determine
1. The number of nutrient foramina.
2. The direction of nutrient foramina.
3. The position of nutrient foramina in relation to the surface.
4. The lengthwise distribution of the nutrient foramina in relation to the shaft.
ANNEXURE – IV
7.0 MATERIALS AND METHODS
7.1 SOURCE OF DATA
Metatarsals and Metacarpals obtained from the
Ø Cadavers
Ø Dry specimens of Metatarsals and Metacarpals obtained and studied in
§ Navodaya Medical College, Raichur
§ Raichur Institute of Medical Sciences, Raichur
§ Other nearby Colleges in Karnataka and Andhra Pradesh
Other materials used for study are
Ø Hand Lens
Ø Dissecting Microscope
Ø Thin straight wire
Ø Scale
7.2 Method of Data Collection
a. Sample size : It is proposed to study Metatarsal and Metacarpals 100 each including both right and left
b. Method of Sampling: Metatarsals and Metacarpals obtained from the Cadavers cleaned of soft tissues and bleached in Hydrogen Peroxide and dried.
c. Method of Observation: The nutrient Foramina are distinguished by the presence of well marked grove, leading to a foramen by a well marked and often slightly raised edge of the foramen at the commencement of the canal. In doubtful cases a dissecting microscope or Hand lens is used to locate the foramen. For the direction of the canal fine stiff straight wire will be passed through the foramen to confirm its direction.
Three times the observations will be repeated and the result will be tabulated as follows
TABLE - 7.1 Study of Number of Foramina in 1000 Bones
TABLE - 7.2 Study of Direction of Foramina in 1000 Bones
TABLE - 7.3 Study of Relation of Foramina with surface in 1000 Bones
TABLE - 7.4 Study of Lengthwise Distribution of Foramina relation to the
Shafts in 1000 Bones
7.3. DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVENTIONS TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS. IF SO PLEASE DESCRIBE BREIFLY.
No investigation / Intervention required on patients
7.4. HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3
YES
ANNEXURE - V
08. LIST OF REFERENCES
1. BERARD A, 1835, Archives Generale de Medicine. II series 7, 176-183.
2. CHAURASIA B.D – Hand book of General Anatomy 3rd Edition Page 35-36
3. HUGHES, H. 1952, The factors determining the direction of the canal for the nutrient artery in the long bones of Mammals and Birds. Acta Anatomica 15, 261-286.
4. HENRY GRAY’S Anatomy 38th Edition (1992) Page 469
5. LE GROS CLARK, W.E. 1965, The tissues of the Body P-117, Oxford Clarendon Press.
6. PATAKE.M & MYSOREKAR V.R (1976) J.Anat (1977), 124, 2pp299-304
7. MALUKAR OJASWINI & JOSHI HEMANG NJIRM 2011 Vol 2 (2) April-June Special
8. SRIMANKAR P.S, TRIVEDI D.J & KARIA V.B NJIRM 2010 Vol 1 (2) April-June
9. SINGH.I. 1959 Variations in The Metacarpal Bones, Journal of Anatomy 93, 262-267
10. SINGH.I. 1960 Variations in Metatarsal bones, Journal of Anatomy 94, 345-350
11. WOOD JONES, F 1946 Buchanan’s Manual of Anatomy, pp 310, 367, London, Bailliare, Tindall and Cox.
CURRICULAM VITAE OF GUIDE
NAME : DR. H.S.KADLIMATTI
DESIGNATION : PROFESSOR
DEPT. OF ANATOMY
NAVODAYA MEDICAL COLLEGE
RAICHUR
QUALIFICATION : M.S ANATOMY
CURRICULAM VITAE OF THE STUDENT
NAME : DR. RATNA PRABHA J
DESIGNATION : P.G STUDENT IN ANATOMY
DEPT. OF ANATOMY
NAVODAYA MEDICAL COLLEGE
RAICHUR
QUALIFICATION : M.B.B.S (J.J.M MEDICAL COLLEGE, DAVANAGERE, KARNATAKA)