A Study on Variations of Nutrient Foramen of Fibula in Saurashtra Region with its Clinical Relevance

Abstract

Introduction: Nutrient foramen is an opening into shaft of fibula which gives passage to the blood vessels of medullary cavity. The knowledge of nutrient foramen is important in surgical procedures like bone grafting and more recently in microsurgical vascularized bone transplantation. Objective: To determine the number, location and direction of nutrient foramen and whether the nutrient foramens obey the rule of ossification, that is directed away from the growing end of the bone or not.  Subjects and Methods: The present study consisted of 150 (75 right and 75 left) dried fibula bones excluding any fracture or pathological abnormalities Number and direction of nutrient foramen was observed in each fibula. Location of nutrient foramen in relation with surfaces and zones of fibula was determined. Results: It has been observed that 96.67% of the fibula had a single nutrient foramen, 3.33% double foramen and no bone had 0 nutrient foramen. It was concluded that 98.71% of the nutrient foramina were present on the posterior surface and 1.29 % on medial crest. It was also concluded that most (98.06%) of the foramina present in the zone II followed by zone III (1.29%) then by zone I (0.65%). All foramina were directed toward the upper end of fibula. Conclusion: By knowing the number and location of the nutrient foramina in fibula would be useful in preventing intra-operative injury of nutrient artery during orthopedic, plastic and reconstructive surgery and will also be relevant in medico legal practice.