Morphological and topographical anatomy of nutrient foramina in human clavicles and their clinical importance

Abstract

The aim of our study was to determine the number, direction, position of nutrient foramen and whether the nutrient foramina obey the general rule that is, directed away from the growing end of the bone. The study comprised 40 clavicles, which were obtained from the anatomy department of Career Institute of Medical Sciences and Hospital. The clavicles were macroscopically observed for the number, location and direction of the nutrient foramina. The foramen index was calculated for each clavicle by applying the Hughes formula. The neurovascular foramen was observed in all 40 (100%) clavicles. Total 65 foramina were observed. 15.4% foramen was present at the medial 1/3 rd region, 73.8% at the middle 1/3 rd region and 10.8% at the lateral 1/3 rd of clavicles. 35.4% foramen were on inferior and 64.6% foramen were on posterior surface of clavicles. The foramen was single in 17 (42.5%) clavicles, double in 21 cases (52.5%), and there were more than 2 foramina in 2 clavicles (5%). The foramen was present at the medial 1/3 rd region in 19.2% clavicles, at the middle 1/3 rd region in 67.3% and at the lateral 1/3 rd part in 13.5% clavicles. It was on the inferior surface in 42.6% clavicles and on the posterior surface in 57.4%. The average distance of the foramen from the sternal end was 6.76 cm (67.6 mm) and the mean foraminal index was 48.01. Nutrient foramina play an important role in nutrition and growth of the bones. The knowledge of nutrient foramen is important in surgical procedures like bone grafting and in microsurgical vascularised bone transplantation.