A Topographical Study of Nutrient Foramen in Human Fibulae

Abstract

Introduction: The fibula is very well known amongst the surgeons for their usage in bone grafting. The vascularised bone graft is necessary for successful procedure. The vasculature of the bone graft is maintained by procuring the intact nutrient artery along the donor site of the bone. The nutrient artery enters the shaft of the bone through the nutrient foramen. The topographical study of nutrient foramen in human fibulae will benefit the operating surgeons in the surgical procedures like open reduction fracture of the fibula and bone grafting. Aim: To record the position, location, number and direction of the nutrient foramen of the fibula. Materials and Methods: A descriptive study on 100 human dried fibulae obtained from the Department of Anatomy, Seth GSMC and KEM hospital, Mumbai, Maharashtra, India were done from February 2013 to July 2013. A magnifying hand lens and a thin stiff wire to confirm the number and direction of nutrient foramen were used. The lengths of the fibulae were measured and divided into three equal parts. The position and location were determined by identifying the anatomical position and the side of the fibula. The simple statistical method by calculating frequency (n) and percentages (%) in all categories and sub-categories of the collected data was applied to the study. Results: In 17.24% of fibulae the foramen was directed towards the growing end. In 7% of fibulae, there was no foramen, 23% fibulae were having two foramina, and 70% were having one foramen. The nutrient foramen was located maximally on the posterior surface of the fibula (84.48%) and in the middle one- third (81.03%). Conclusion: This study has provided information on the topography of nutrient foramen of the fibula. This knowledge will be useful in certain surgical procedures to preserve the vascularity of fibula.