Twenty-nine percent of bones showed absence of vascular foramina on medial surface. Thus, in present study the navicular bone showed absence of vascular foramina on proximal and distal surfaces. Navicular stress fractures accounts for 14% to 35% of all stress fractures and presents with increasing pain in the dorsal mid-foot. Foot pain is a very common symptom in patients with orthopaedic problems. This robust ligamentous network can only be disrupted in the setting of high-energy trauma causing displaced navicular fractures. The plantar and dorsal cuboideo-navicular ligaments connect navicle with cuboid. The plantar and dorsal cuneo-navicular ligaments connect the cuneiforms with the navicle. The talo-navicular ligament is attached to the dorsal surface of the navicle. The anterior part of the deltoid ligament is attached to the navicular tuberosity. The calcaneonavicular part of the bifurcate ligament is attached to the rough part of the lateral surface of the bone. The navicular bone gives attachment to the plantar calcaneonavicular (spring) ligament lateral to the navicular tuberosity adjacent to the proximal surface. The tarsal navicular bone forming a part of medial longitudinal arch plays an integral role in the hind foot motion and gait. The position of the navicular bone in the foot is compared with position of scaphoid bone of the hand and hence the term navicular bone or hand navicular bone was formerly used for the scaphoid bone. Table 2 summarizes the distribution of foramina on various surfaces between the right and left navicular bones. In total of 604 foramina observed on the dorsal surface, 376 foramina (62.3%) were located within 50% length of the navicular bone. On the dorsal surface 56% of the bones exhibited ≥6 foramina and 44% of the bones exhibited <6 foramina. The number of the foramina at the dorsal surface varied between 3 to 10 with a mean of 6 foramina ( Table 1). On the medial surface the foramina ranged between 0 to 4, lateral surface ranged between 1 to 6 and plantar surface between 1 to 10. The number of foramina ranged from 1 to 10 in each navicular bone. Mann-Whitney U test done for post hoc analysis showed the total number of nutrient foramina observed on dorsal surface were significantly greater than the number observed on the plantar (U=2,755, P=0.001), medial (U=43, P=0.001), and lateral (U=626.5, P=0.001) surfaces of the navicle ( Table 1). Kruskal-Wallis test showed that there was a statistically significant difference in total number of nutrient foramina between the different surfaces of navicle, χ 2(3)=263.4, P=0.001, with a mean rank foramina number of 316.2 for dorsal surface, 251.3 for plantar surface, 68.5 for medial surface, and 165.9 for lateral surface. Keywords: Navicular, Stress fractures, Vascular foramina We believe the present study has provided additional information on the vascular foramina of navicular bone and useful to surgeons in foot surgeries. Spearman's rank correlation coefficient done showed a strong, positive correlation between vascular foramina of <1 mm size and circular shape, which was statistically significant ( r s=0.981, P=0.001). About 96.7% of vascular foramina were <1 mm in size and 3.3% were ≥1 mm in size. About 97.6% of foramina were circular and 2.5% were oval in appearance. Kruskal-Wallis test followed by series of Mann-Whitney test for post hoc analysis showed the number of nutrient foramina observed on dorsal surface were significantly greater than those observed on the plantar (U=2,755, P=0.001), medial (U=43, P=0.001), and lateral (U=626.5, P=0.001) surfaces of the navicle. The vascular foramina were present on dorsal, plantar, medial, and lateral surfaces of navicular bone. The data collected were statistically analyzed. The bones were macroscopically studied for vascular foramina with respect to its location, number, size, and shape. The study was carried out by using 100 navicular bones (50 right and 50 left) collected from our institute and other medical institutes in and around Puducherry. The objective of the present study is to analyze the morphology and morphometry of vascular foramina of dried human navicular bone in Indian population. The knowledge about the vascular foramina is important to understand the pathogenesis and management of navicular fractures. The navicular bone is supplied by more than one artery.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |