An Anatomical Study of the Tibia in the North Indian Population

Introduction: The human tibia is a complex anatomical unit and the knowledge of its morphometric values is important in Forensic, Anatomic and Radiological cases in order to identify unknown bodies and stature. Objective: It was to analyze the tibia, its morphometry, side difference and to investigate the position of nutrient foramina in tibia. Methods: In this study, 60 adult human tibias (30 right and 30 left) were obtained from the Department of Anatomy SMSR SHARDA UNIVERSITY. In the study a total of two parameters i.e. Cross Section Index in the middle and Cnemicus Index of the bones were obtained and evaluated by using two instrumentsa Measuring Tape and a Vernier Calipers. All the bones were dry and showed normal anatomical features. Results: The mean Cross Section Index in the middle was calculated as 80.42 ± 11.33 on the right side and 78.15± 12.78 on the left side; and the Cnemicus index was 78.40 ± 13.19 on the right side and 70.84 ± 11.38 on the left side Conclusion: The two parameters in the North Indian population were compared with other populations. The values were found to be almost comparable however there were subtle differences between different populations. The position of nutrient foramen was also assessed. This knowledge will thus help further researchers and orthopedic surgeons in various procedures like joint replacement therapy, fracture repair, bone grafts and vascularized bone microsurgery as well as in medico‐legal cases. DOI : 10.14302/issn.2577-2279.ijha-19-3053 Corresponding author: Aman Tiwari, MBBS II Year, School of Medical Science & Research, Sharda University, Greater Noida, Email: amant29298@gmail.com


Introduction
The tibia is situated at the medial side of the leg; and excepting the femur, is the longest bone of the skeleton [1]. The anterior border of the tibia is the most prominent border. The anterior border and the adjacent medial surfaces are subcutaneous throughout their length and are commonly known as "shin" [2].
The tibia ossifies from three centers, one in the diaphysis and one at each proximal and distal epiphysis.
The medial malleolus is merely an extension from the distal epiphysis [3].
The nutrient artery is the main source of blood supply to a long bone which enters the bone through the nutrient foramen. This artery is very important for the growth of bone in embryo and fetus as well as during the early ossification phase of bone [4].
Study of comparative association between length of bone and distance of nutrient foramen from either end is beneficial in calculating the length of a long bone which is significant in medico-legal and anthropometry work. From the length of the bone, the stature of an individual can also be found out [5].
Also, an understanding of the location and the number of the nutrient foramina in long bones is vital in various orthopedic surgical procedures such as joint replacement therapy, fracture repair bone grafts and vascularized bone microsurgery [6].
Hence, the present study was carried out to measure various dimensions of tibia to calculate the Cross-Section and Cnemicus Indices in an endeavor to provide a base line data pertaining to morphometric details of tibia with reference to knee arthroplasty in the North Indian population. The results of the study assume a special importance in view of technical advances in reconstructive surgical procedures in orthopedic practice.

Material and Methods
The present study was carried out on 60 tibias,

Results
The mean Cross Section Index in the middle was calculated as 80.42 ± 11.33 on the right side and  Figure 1 and 2]. The most common location of the foramen was seen on the posterior surface in the upper one third of the bone.

Discussion
The vertically oriented tibia lies medial to, and is stronger than, the accompanying fibula. The tibia's proximal end, the tibial plateau, provides a surface for articulation with the femur, thereby allowing transmission of the body's weight as well as ground reaction forces. When both forces are transmitted strongly, as in jumping from an elevated position, the knee joint and its internal elements are at increased risk for injury. Additionally, when the angulation of the femur and tibia is other than normal, significant changes take place in the weight-bearing pressures on the menisci and cartilage [7]. undertaking an open reduction of a fracture to avoid injuring the nutrient artery and thus lessening the chances of delayed or non-union of the fracture.

Conclusion
The present study is an endeavor to provide a base line data pertaining to morphometric details of tibia with reference to knee arthroplasty in the North Indian population. The results of the study assume special importance in view of the technical advances in reconstructive surgical procedures in orthopedic practice. The morphometric parameters obtained and the indices derived, differed among the different studies.
These differences may be due to delicate variations in the measurements as well as due to the individual differences that exist in different populations.