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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Anatomical Localisation and Morphometric Study of Lister's Tubercle of Radius: A Cross-sectional Study
Correspondence Address :
Hina Bhulabhai Rajput,
C-190, San Tropez, Madrid County, Opposite Ashapura Temple, Bhayli Station Road, Vadodara-391410, Gujarat, India.
E-mail: drhinarajput81@gmail.com
Introduction: Fractures of the distal radius are one of the most common injuries and it accounts for 8-15% of all fractures of the upper limb. Lister’s Tubercle (LT) is an important anatomical, surgical landmark during various orthopaedic and other surgical procedures on the distal radius.
Aim: To determine the anatomical localisation of LT in relation to radial styloid process and ulnar notch and to measure the morphometric parameters of LT on dry radii.
Materials and Methods: The present cross-sectional study was done on 180 radii, 90 right-sided and 90 left-sided obtained from the Department of Anatomy, Medical College Baroda, Vadodara, Gujarat, India, from December 2021 to August 2022. Localisation and length, width and height of the lister tubercle were measured with the help of a vernier calliper. Mean and range of each parameter was calculated. All measurements were made by two observers to avoid bias interpretation. The data were entered in Microsoft Excel window 10.
Results: On right-side the LT was nearer to the styloid process in 04 radii (ratio was less than 1) while it was nearer to the ulnar notch in 86 radii (ratio was more than 1). Highest ratio of two distance was 1.768 (LT nearer to ulnar notch) while the lowest distance was 0.8706 (LT nearer to styloid process). On left-side LT was nearer to styloid process in 28 radii (ratio was less than 1) while it was nearer to ulnar notch in 62 radii (ratio was more than 1). Highest ratio of two distance was 1.42 (LT nearer to ulnar notch) while the lowest distance was 0.79 (LT nearer to styloid process). The mean length of LT on right-side was 12.30±1.46 mm, breadth 4.66±0.98 mm, while height was 2.87±0.57 mm and the mean length of LT on the left-side was 13.19±1.511 mm, width 4.89±1.17 mm, while the height was 2.96±0.692 mm.
Conclusion: The present study shows that in majority of cases, LT was nearer to the ulnar notch and the distance between LT and radial styloid process was more. The anatomical localisation and morphometric data of LT will be is useful in various surgical procedures like screw fixation in volar plating and micro nail techniques.
Dorsal tubercle, Micro nail, Radial nerve, Volar plate fixation
The posterior surface of distal end of radius displays a palpable dorsal tubercle or LT which is in line with the cleft between the index and middle fingers. LT receives a slip from the extensor retinaculum and is grooved medially by the Extensor Pollicis Longus (EPL) tendon. LT acts as bony fulcrum around which EPL changes its line of pull from the forearm to the thumb. As a consequence of the obliquity of its tendon, EPL adducts the extended thumb and rotates it laterally (1). The vascularity of distal radius has importance in the new surgical approach of the distal radius and new techniques of osteosynthesis like K-wire placement and micro nail technique for distal radius fractures. The dorsal epiphyseal vessels of the lower end radius enter through the LT and palmer interosseous vessels enter the bone at the level of LT (2),(3),(4).
Fractures of the distal radius are one of the most common injuries and it accounts for 8-15% among all the fractures of the upper limb. Thus, the morphometric evaluation of distal radius is important for evaluation and treatment of the injuries around the wrist (5),(6). The LT is used as an anatomical landmark for localising the anatomical variants like the 1st dorsal extensor compartment, Posterior interosseous nerve, superficial branch of radial nerve, dorsal radio-triquetral ligament (7),(8),(9),(10). Further, LT is also used as a surgical landmark in wrist arthrography injections and arthroscopy, dorsal wrist capsulotomy, hand microsurgery, radio scapholunate arthrodesis, Kirschner wire placement and internal fixation of Colle’s fracture and the insertion of square and elastic intramedullary nails for fixation of diaphyseal fracture of radius (2),(9),(11),(12).
The EPL tendon ruptures are common complication of distal radius fractures. A spontaneous rupture of the EPL tendon is associated with rheumatoid arthritis, fractures of the wrist, systemic or local steroids and repetitive and excessive abnormal motion of the wrist joint like in kick boxers and tailors (13),(14). The EPL tendon can rupture without severe trauma or inflammatory diseases as there is poor vasculature around the LT. The EPL has proximal and distal blood supply with a relatively avascular zone around the LT (15). The spontaneous rupture without trauma, could occur due to attrition of the EPL tendon around LT (16),(17). The LT is an important anatomical and surgical landmark during various orthopaedic procedures. To identify nearby anatomical structures, the localisation of LT is required.
The aim of the present study was to determine the anatomical localisation of LT in relation to the radial styloid process and the ulnar notch and to measure the morphometric parameters of the LT on dry radii.
A cross-sectional observational study was conducted in the Department of Anatomy, Medical College Baroda, Vadodara, Gujarat, India, from the December 2021 to August 2022. A total of 210 adult human radii of unknown age and sex were obtained from the bone store and out of 210 radii, after satisfying inclusion and exclusion criteria, only 180 radii (90 of each side) were used for the present study.
Inclusion criteria: Dry, clean and anatomically normal adult radii, were included in the study.
Exclusion criteria: Radii with any structural deformity, previous radial trauma, and any other pathological irregularities such as arthritis and any gross breakage, were excluded from the study.
Study Procedure
At the distal end of radius bone, the LT was identified and localisation and length, width and height of LT were measured with the help of vernier calliper.
Localisation of Lister’s Tubercle (LTLT) (11),(18): Three anatomical landmarks were identified on each radius (Table/Fig 1).
A line was drawn between point B and point C (Line BC). Another perpendicular line was drawn from point A to line BC. Intersecting point was labelled as point D.
Distance BD (D1)- Distance between the mid-point of ulnar notch to intersecting point was noted in mm. Distance CD (D2)- Distance between mid-point of radial styloid process to intersecting point was noted in mm. Maximum and minimum distances of LT were noted and their mean and standard deviation were calculated. The ratio of two measurements (D2/D1) was calculated to find out the location of LT in relation to the mid-point of the radial styloid process and the mid-point of the ulnar notch. If the ratio was more than 1 that indicates the LT is nearer to the ulnar notch, while if the ratio was less than one that indicates the LT is nearer to radial styloid process. Morphometry of LT (7),(19),(20). Length, width and height of LT were also measured with the help of a digital vernier calliper (Table/Fig 2),(Table/Fig 3),(Table/Fig 4),(Table/Fig 5).
Point R- Highest point on the LT, Point P and point Q- Proximal and distal ends of the LT, respectively.
Point S and point T- Medial and lateral ends at the maximum broadness of the LT
• Length (mm)- Distance between the point P and point Q.
• Width (mm)- Distance between the point S and point T.
• Height (mm)- Distance from point R to floor of EPL groove.
Mean and range of each parameter were calculated.
Statistical Analysis
All measurements were made by two observers to avoid the bias interpretation. The data were entered in Microsoft Excel window 10 and descriptive statistics was used.
All 180 radii showed the LT on its dorsal aspect. On the right-side, the distance from the LT to the styloid process ranged between 9.86 mm to 17.34 mm, while distance from the LT to the ulnar notch ranged from 7.75 mm to 15.25 mm. In the present study, the LT was nearer to the styloid process in 04 radii (ratio was less than 1) while it was nearer to the ulnar notch in 86 radii (ratio was more than 1). The highest ratio of the two distance was 1.768, while the lowest ratio was 0.8706.
On the left-side, the distance from the LT to the styloid process ranged between 10.15 mm to 16.74 mm, while distance from the LT to the ulnar notch ranged 9.76 mm to 14.81 mm. The LT was nearer to the styloid process in 28 radii (ratio was less than 1), while it was nearer to the ulnar notch in 62 radii (ratio was more than 1). Highest ratio of two distance was 1.42, while the lowest ratio was 0.79.
The range and the mean values for the localisation, length, width and height of LT is given in (Table/Fig 6).
The LT is an important clinical and anatomical landmark. Its location and morphometric study are useful in various procedures. This data will be helpful in performing accurate procedures and avoiding injury to nearby structures. The comparison of localisation of the LT with the past studies is shown in (Table/Fig 7) (8),(11),(18). Kumar P and Sharma A studied 50 radii (8). They found the LT was near to the radial styloid process in 13 radii, while it was nearer to the ulnar notch in 37 radii. Ojha P and Ojha AK found that out of 52 radii, the LT was nearer to the radial styloid process in 39 (75%) radii while in 13 (25%) radii it was nearer to the ulnar notch (11). Agir I et al., studied 20 radii and found that in 11 radii the LT was nearer to the styloid process, while in nine subjects, it was near or to the ulnar notch (18). In the present study, out of 90 right radii, the LT was nearer to the radial styloid process in 04 (4.5%) radii while it was nearer to the ulnar notch in 86 (95.5%) radii, while on the left-side out of 90 radii, the LT was nearer to the styloid process in 28 (31%) radii while it was nearer to the ulnar notch in 62 (69%) radii. The present study revealed that in majority of cases (82.22%) LT lies nearer to the ulnar notch. Kumar P and Sharma A also found same results, while study of Ojha P and Ojha AK and Agir I et al., showed that LT was nearer to the radial styloid process (8),(11),(18).
The length, height and width of LT of the present study is compared with the past studies (Table/Fig 8) (7),(19),(20). The comparison showed that in the present study the length of LT was more than the length measured by Shanthi KC (20); while it was less as compared to studies of the Harini P and Mohanraj KG and Clement H et al., (7),(19). In present study, height of LT was less as compared to study of Clement H et al., (19), while width of LT was also less as compared to study of Harini P and Mohanraj KG (7). This data variation could be due to difference in numbers of sample. Ali AM et al., had dissected 16 embalmed forearms to identify a safe surgical zone to avoid injury of Superficial Radial Nerve (SRN) during Kirschner wire fixation in treatment of distal radial fractures (21). They found mean distance between the LT and the closest branch of the SRN was 2.7 cm (SD=0.52).
Samarakoon LB et al., studied relation of LT and sensory branches of Radial nerve in 25 forearm and wrist in cadaver, they found that the mean distance to the point where the most medial and the most lateral superficial sensory branches of the radial nerve cross the wrist joint were 2.51 cm (SD=0.5) and 3.90 cm (SD=0.64) from the LT, respectively (10). He suggested to avoid transverse incision in the snuff box region between 2.5 cm and 3.9 cm from the LT as the risk of damaging the branches of the nerve is very high.
Triphonydis M et al., studied the distance of the SRN branches from the LT, the ulnar styloid and the radial styloid processes (22). They found that the distance of a nerve branch to the LT is greater. They recommended to consider this findings while planning to do percutaneous pinning of distal radial fractures and when possible, the LT may be utilised as an entry point instead of the radial styloid.
Limitation(s)
The present study could not comment on gender differences of LT, but these deprived data can be fulfilled by cadaveric or radiological study.
The present study concludes that in majority of cases, anatomical localisation of LT was nearer to the ulnar notch and the distance between the LT and the radial styloid process was greater. This knowledge can be utilised in the management of distal radius fractures. The length, width and height of the LT is variable and these data should be considered, while operating on distal radius like screw fixation in volar plating and micro nail techniques.
DOI: 10.7860/JCDR/2023/61484.17988
Date of Submission: Nov 19, 2022
Date of Peer Review: Jan 06, 2023
Date of Acceptance: Mar 25, 2023
Date of Publishing: May 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? NA
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA
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