Anatomical study of sacral hiatus in South Indian population and its clinical significance in caudal epidural anaesthesia

Abstract Background: Caudal anaesthesia is administered into the epidural space through Sacral Hiatus(SH). Hence reliability and success of caudal epidural anaesthesia depends upon the anatomical knowledge of sacral hiatus. Aim: The aim is to study the morphological measurements and variations of structures around the sacral hiatus and to identify possible anatomical reasons for failure of caudal epidural anaesthesia (CEA). Materials and methods: Fifty three dry adult sacral bones of both sexes were measured using Vernier Caliper, scale and divider. The shape of sacral hiatus (SH) was observed and its length and breadth were measured. The measurements were focused on sacral hiatus and its relation with surrounding bony projections. Results: The shape of the sacral hiatus showed a maximum occurrence of inverted 'V' and 'U' shapes with 35.85% and 26.42% respectively. The level of apex of SH was maximum at S4 foramen level in 68.63% cases followed by S5 and S3 level. In 62.26%, the level of base was observed at S5 level . The average length of the sacral hiatus was 23.02(± 8.95 mm), APdiameter was 5.49 (±l.44 mm) and base of SH was 14.6 (± 3.99 mm). The distance from apex and base of SH to S2 foramen level was 31.07 mm and 52.86 mm respectively. Conclusion: The anatomical knowledge of SH is very much necessary to increase the reliability and success of CEA. Surrounding bony irregularity, different shapes of hiatus and defect in dorsal wall of sacral canal should be taken into consideration before undertaking CEA so as to avoid its failure.

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Sacral Hiatus Study in Dry Human Sacra

Janaki Medical College Journal of Medical Science ◽

10.3126/jmcjms.v2i1.11391 ◽

2014 ◽

Vol 2 (1) ◽

pp. 17-22

Author(s):

M Mishra ◽

AK Singh ◽

P Satyavathi ◽

N Sah

Keyword(s):

Epidural Anaesthesia ◽

Andhra Pradesh ◽

Medical Science ◽

Anatomical Variations ◽

South Indian Population ◽

South Indian ◽

Caudal Anaesthesia ◽

Sacral Hiatus ◽

Sacral Canal ◽

Caudal Epidural

Background and objectives: The sacral hiatus is the site for caudal epidural anaesthesia during perineal surgery and also for a painless delivery. It is also used for three dimensional colour visualization of lumbosacral epidural space in orthopaedic practice for diagnosis and treatment. Work on the morphometrical study of the sacral hiatus is limited, especially in south indian population. So this study is carried to examine, measure and record the morphometry of sacral hiatus in order to study the anatomical variations which will be useful for caudal epidural anaesthesia. Material and Methods: The study was conducted in the Department of Anatomy, Prathima Institute of Medical Science, Naganur, Andhra Pradesh. 93 dry sacra with complete sacral hiatus were taken for the study. The shape of the sacral hiatus was noted by naked eye. Level of the apex and base of the sacral hiatus was noted with respect to the sacral vertebra. The length of sacral hiatus was measured from apex to the midpoint of base, the anteroposterior depth of sacral hiatus at the apex was measured with the help of vernier calipers. The transverse width of sacral hiatus at the base was measured between the inner aspects of inferior limit of the sacral cornu with the help of divider and then adjusted, and calculated with vernier caliper. Results: In 47 (50.53 %) sacra the shape was Inverted-U and in 25 (26.9 %) sacra Inverted-V. The irregular shaped of sacral hiatus was observed in 11 (11.8 %) cases. A “Dumbbell” shaped sacral hiatus was observed in 5 (5.4%) cases with a nodular bony growth projecting medially from both margins. The dorsal wall of sacral canal was entirely absence in 4 (4.3%) cases. Absence of sacral hiatus, a rare phenomenon, was observed in 1 (1%) specimens only. Conclusion: In the present study, elongated hiatus and narrowing of the sacral canal at apex of sacral hiatus was found in a significant percentage, which should be kept in mind while giving the caudal anaesthesia in Andhra Pradesh region. DOI: http://dx.doi.org/10.3126/jmcjms.v2i1.11391 Janaki Medical College Journal of Medical Sciences (2014) Vol. 2 (1): 17-22

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Estimation of the Humerus Length by its Proximal Segments: A South Indian Anatomical Study

Journal of Morphological Sciences ◽

10.1055/s-0039-1685223 ◽

2019 ◽

Vol 36 (02) ◽

pp. 067-071

Author(s):

Kasargod Umesh Prashanth ◽

Mangala Manohar Pai ◽

Bukkambudhi Virupakshamurthy Murlimanju ◽

Latha Venkatraya Prabhu ◽

Manoor Dass Prameela

Keyword(s):

Indian Population ◽

Anatomical Study ◽

South Indian Population ◽

Regression Equations ◽

Morphometric Data ◽

The South ◽

South Indian ◽

Pearson Coefficient ◽

Best Parameter ◽

The Right

Introduction To determine the morphometric data of the proximal segments of the humerus in the South Indian population, and to obtain the regression equations that will enable us to predict the whole length of humerus. Materials and Methods The present study included 166 dried adult human humeri. Their lengths were measured by using the osteometric board. The seven proximal segment lengths of the humeri were assessed by using a digital Vernier caliper (Mitutoyo Corporation 150 mm/6 inch, model number 500-196-20, Kawasaki, Japan). Results The mean humerus length in the present study was 30.75 ± 2.03 cm on the right side and 30.27 ± 2.28 cm on the left side. The comparison between the right and left sides of the proximal segments of the humerus did not yield statistically significant results (p > 0.05). The present study observed that the relationship between the dimensions of the proximal segments of the humerus and the length of humerus were strong (p = 0.00). The oblique length between the most proximal and distal points over the anatomical neck was the best parameter to predict the length of humerus (the Pearson coefficient was 0.78 for the right side and 0.77 for the left side). Conclusion The simple regression formulae, which were derived in this study, are helpful in the estimation of the length of the humerus. The formulae can be used in forensic investigations, in which the stature of a person has to be determined and only bone fragments are available. The morphometric data of the present study have implications in archaeological and anthropological studies. The data are enlightening to orthopedicians, when planning reconstructive surgeries of the proximal end of the humerus in the South Indian population.

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