Direction Of Nutrient Foramina Research Articles

ANATOMICAL STUDY OF NUTRIENT FORAMINA IN LONG BONES OF HUMAN UPPER AND LOWER LIMBS

Aims and Objectives: The objectives of the study are as follows: (1) To determine the number, location, position, and direction of nutrient foramina in the shaft of long bones. (2) To determine the foraminal index of the long bones. Methods: This was a cross-sectional study, undertaken on dry cadaveric human long bones of unknown age and sex from the Department of Anatomy, M.S. Ramaiah Medical College, Bangalore. The duration of study was 2 years. In this study, 350 human long bones which include the clavicle, humerus, radius, and ulna from the upper extremity; femur, tibia, and fibula from the lower extremity were examined in detail for the number, position, location, and directions of the nutrient foramen. For statistical purposes, p<0.05 was taken as significant. Results: All the bones had single nutrient foramina and a higher percentage of double nutrient foramina was seen in femur. The most common position was the middle one-third of the shaft and the surface distribution was different in different bones. All the bones had the nutrient foramina, which were directed away from the growing end. The mean foraminal index for clavicle, humerus, radius, and ulna was 52.85±9.24, 56.92±6.57, 34.80±6.07, and 36.0±5.85, respectively. Mean foraminal index for femur, tibia, and fibula was 43.54±10.32, 32.37±3.1, and 51.68±9.77. Conclusion: Knowledge of nutrient foramina of long bones is crucial for orthopedic surgery, forensic identification, obtaining vascularized bone grafts, and treating trauma or malignant bone conditions.

Morphometric and Topographic Study of Nutrient Foramen in Human Clavicle in North India

Background& Aims: The Clavicle also known as Collar bone is the only long bone of the human skeleton which is placed horizontally. The vascularized bone like clavicle helps principally in bone grafting and joint allograft. The morphometrical and topographical knowledge of nutrient foramina is very important in surgical and orthopaedical procedures. The aim of this study is to determine the number, position, location and direction of nutrient foramen in human clavicle bones. Material and methods: The present study was conducted on 60 human dry adult clavicle bones of unknown age and sex, which were obtained from the Department of Anatomy, Govt Medical college, Jammu. Results: The nutrient foramen was present in all 60 (100%) clavicle bones. One nutrient foramen was present in 63.3%, two in 28.3% and three in 8.3% of clavicles. Total 87 nutrient foramina were observed in our study. The nutrient foramina were predominantly located in the middle 1/3rd of the clavicle bones. In addition, the predominant position of nutrient foramen was on inferior surface of clavicle. The direction of nutrient foramina in all clavicle bones was towards the acromial end in present study. Conclusion: The knowledge of nutrient foramina is very important in surgical and orthopaedical procedures like bone grafting and more recently in microsurgical vascularised bone transplantation. Keywords: Morphometric and topographic study, nutrient foramen, human clavicle

TOPOGRAPHY OF NUTRIENT FORAMINA OF ADULT DRY RADII IN SOUTH INDIAN POPULATION WITH A NOTE ON ITS SURGICAL RELEVANCE

Objective: The objective of this study was to study the average length of adult dry radii in south Indian population, distribution of nutrient foramina, and foraminal index. Methods: This study was conducted using 200 dry, adult radii, obtained from the department of Anatomy at our institute. Fully formed radii of both sides and genders were included in the study. Length of each bone, distribution, and direction of nutrient foramina on diaphysis were studied with the help of a Vernier caliper. Later, foramen index was estimated for all bones using Hughes formula. The data were tabulated and analyzed statistically. Results: Average length of radii in the study was 23.37±1.65 cm. All radii had their nutrient foramina, directed proximally. About 2% of the study sample had double nutrient foramina. Increased number of foramina had no effect on length of bone. As many as, 57.5% of radii had nutrient foramen on the anterior surface of shaft. Mean foramen index was 34.24±4.75. Conclusion: This study provides population-specific data regarding length of adult radii and topography of nutrient foramina of adult radii. An attempt was made to acknowledge its relevance while harvesting a vascular graft.

Morphological Study of Nutrient Foramina in Long Bones of Upper Limb among North Gujarat Population

Introduction: Main source of nutrition to long bone during growth and ossification is nutrient artery. Nutrient canal opens as nutrient foramen on the surface of shaft which conducts the nutrient artery and the peripheral nerves to bones. Nutrient artery provides more than 60-70% of blood supply to long bone, 30- 40% through periosteal, metaphyseal and epiphyseal blood vessels. Aim: To determine number of nutrient foramina, its position on surface of shaft, size and direction of nutrient foramina either towards proximal end or distal end and find out foraminal index from the position of nutrient foramina. Materials And Methods: A cross-sectional study was performed in 177 dry bones (60 humerus, 60 radius, 57 ulna) of upper limb, available at Anatomy Department, GMERS Medical College Himmatnagar, during September 2021. All bones were observed for number, position and direction of nutrient foramina. Size of foramen was measured by needles of different size. Mean Foraminal index was calculated for each long bone of upper limb by using Epi Info™ for windows, CDC, Atlanta, version 7.2. Results: Majority of bones had single nutrient foramina, all foramina were directed towards the elbow joint. All nutrient foramina were on flexor surfaces of bone, except one bone (radius). Majority of nutrient foramina were situated on middle 3rd of the shaft. Size of nutrient foramen was range from 22 to 28 gauge of needle. Conclusion: Information on nutrient foramina of long bones of upper limb will be useful in many orthopedic surgeries like microvascular bone grafting and many plastic reconstructive surgeries. During surgeries like fracture repair, bone graft or muscle graft care should be taken, not to damage these nutrient vessels to keep intact blood supply of bone.

A Study of Diaphyseal Nutrient Artery Foramina of Dry Fibula in Human, done in a Government Medical College of Upper Assam, India

Introduction: The nutrient foramina is the external opening in each bone which has a particular position and number in its diaphysis. A thorough knowledge of the position, number, direction and variation of the nutrient foramina of fibula is very much important, as this is one of the most common bone used in bone grafts, vascularised bone microsurgery and mandibular reconstruction. Aim: To determine the position of nutrient artery foramina in fibula and also their size and direction. Materials and Methods: This was a descriptive cross-sectional study which was conducted in the Department of Anatomy, Assam Medical College, Dibrugarh, Assam, India, from March- June 2021. The study was conducted on 167 numbers of adult human cleaned and dried fibulae. The number, position, size and direction of nutrient foramina were recorded in a pretexted proforma. Foraminal Index (FI) was calculated and the range, mean and standard deviation of FI were determined. Results: In the present study, 167 bones were taken but only 159 showed nutrient foramina. Single dominant foramen was found in 92.5% (147/159) of bones. Secondary foramina were present in 7.5% (12/159) of bones. The FI was calculated. According to FI, maximum number of foramina was present on middle third of fibula (92.56%). In 7.44% of fibula the foramina were located in distal third of the bone. Conclusion: A thorough anatomical knowledge of the nutrient foramen is useful in planning the vascularised fibular graft. Hence the result of this study will provide detail data about the number, position and direction of nutrient artery foramina in fibula for successful outcome of various orthopaedic and plastic reconstructive surgeries.

A Study of Morphometric and Topographic Anatomy of Nutrient Foramen in Fibula

Introduction: Long bones receive its primary blood supply from the nutrient arteries. They are transmitted through oblique canals, called nutrient foramina, into its diaphysis. Knowledge of foraminal topography helps to preserve bone vascularity during surgeries. Aim: To estimate the morphometric and topographic characteristics of diaphyseal nutrient foramina of fibula. Materials and Methods: A descriptive osteometric and morphological assessment of 50 dry fibulae of unknown age and sex were done. The samples were obtained from the Department of Anatomy, Kanyakumari Government Medical College, Asaripallam, Tamil Nadu, India. The length of each bone was measured directly using a measuring tape. Number, location and the direction of nutrient foramina were observed and the data were presented in a tabulated format. Results: The mean height of the fibula on the right side was 35.86±2.441 cm, whereas on the left was 36.64±2.537 cm. It was observed that 92% of the right and 96% of the left bones presented a single foramen. The nutrient foramina were predominately present on the posterior surface of the middle third of the shaft and were directed away from the growing end of the bone. Conclusion: As vascularised osteocutaneous fibular graft is recommended as a useful treatment option for bone transplant surgeries, the data gathered in this study could be useful for the orthopaedic surgeons.

Study of diaphyseal nutrient foramina in human typical lower limb long bones

Higher percentage of the nutrient foramina on femur was double while tibia and fibula showed single nutrient foramina. We studied the number, size, direction and foraminal index of diaphysis nutrient foramines of femur tibiae & fibulae in manner in which other authors studied. For the study, 450 dry bones (150 femora, 150 tibiae and 150 fibulae) of adult subjects of unknown sex & age were used from the Anatomy Museum of Government Medical College Miraj & Other medical colleges in Maharashtra, India. Of the 150 femora, tibiae & fibulae dominant foramina were 120(61.54%), 67(42.14%) & 32(20.38%) respectively and secondary foramina were 75(38.46%), 92(57.86%) & 125(79.62%) respectively. This information will be of great importance to orthopedician surgeons performing surgical procedures of the lower limb fractures. Aim and Objective: A detailed study was conducted for: Number and size of nutrient foramina in human lower limb typical long bones; Direction of nutrient foramina; Foraminal index. Keywords: Femur, Fibulae, Foraminal index, Nutrient foramina, Tibiae, Typical lower limb long Bones.

Study of nutrient foramina of human tibia of Saurashtra region

Introduction: On the shaft of tibia surface openings for entry of blood vasculature is known as nutrient foramen which leads to nutrient canal to provide a pathway for blood vessels to reach medullary cavity. Topographical information about nutrient foramen is very crucial during various orthopedic surgical procedures. Objective:Present study is conducted to find out the number of nutrient foramina, its location and direction in relation to growing end of bone and to calculate foraminal index of human tibia. Material and Methods:In present study 61(30 right and 31 left sided) tibia bone were studied. Age and sex of the bone were unknown. Only fully intact bone without any disease were included. Surface location and direction of nutrient foramina were recorded. Total length of tibia was measured with osteomatric board. Distance of nutrient foramen from proximal end was measured with digital vernier caliper. And foraminal index was calculated. All data was tabulated and analysed statisticaly. Result:Out of total 61 tibia 95.08% of tibia had one nutrient foramen, 3.28% tibia had two foramen and 1.64% were devoid of nutrient foramen. Almost all (98.33%) of the nutrient foramina were detected on the posterior surface, only 1.67% were on lateral surface. Zone I contained 48.33% and Zone II contained 51.67% of foramina. Not a single bone had foramen in Zone III. Direction of all foramina were towards lower end of tibia except one bone. Conclusion:Thorough knowledge of morphology of nutrient foramina is necessary for preserving the nutrient arterial blood supply. Because it is very crucial in bone grafting, fracture healing, joint replacement therapy and vascularised bone micro surgeries. Keywords:Tibia, Foraminal index, Nutrient foramen, Fracture, Morphometry.

Anatomical study of nutrient foramina in humerus

Introduction: Knowledge of nutrient foramina is important in surgical procedures. Objective of present study is to know the number, location and direction of nutrient foramina in diaphysis of humerus and to test the significant difference of total length and foraminal index on right and left side separately. Materials and Methods: Total 100 dried humerii of unknown sex (52 of right and 48 of left side) were taken for present study. The identification of nutrient foramen was confirmed with the help of magnifying lens and metallic wire. The total length of humerus and distance of nutrient foramen from proximal end of humerus was measured by sliding caliper and osteometric board. Foraminal index was also calculated. Results: All the examined bones showed single diaphyseal nutrient foramen. Majority of foramina (81%) were present on middle 1/3 of anteromedial surface of shaft of humerus. The direction of these foramina was similarly found in all bones i.e. towards the elbow joint. There were no significant differences between right and left side for total length and foraminal index. Conclusion: An accurate knowledge of the location of nutrient foramina is important in surgical procedures like reduction of fracture, bone grafting and microsurgical vascularized bone transplantation. Keywords: Humerus, Nutrient foramina, Number, Location, Direction, Foraminal index.

Variations of Nutrient Foramen of Femur and its Clinical Implications

Introduction: Nutrient foramen is the largest opening on the shaft of the femur that conveys nutrient artery into the marrow cavity. Knowledge on locations of nutrient foramina is essential during surgical procedures as well as to rule out if the fracture line passes through the foramina. The purpose of the study was to determine the number and position of nutrient foramina in relation to length and topography of the femur. Methods: The study model was descriptive, cross-sectional study that included 151 femurs (71 right and 80 left side). The total number, location, and direction of nutrient foramina were investigated. Total length of femur and distance of foramen from the proximal end was measured with the 500mm 20 Digital Vernier Nib Jaw Caliper Metric/ Imperial Machine-DRO and finally Foraminal Index was calculated. Results: The analysis revealed 119(78.81%) of the femurs with single nutrient foramen, 31(20.52%) with double and 1(0.67%) with triple nutrient foramina. Foraminal Index II was found in 74(86.05%) on right side and 90(91.84%) on left side. The most common location of nutrient foramen was the medial lip of linea aspera (n= 77, 41.85%). All of the foramina were directed towards the proximal end. Conclusion: The present study has reported the majority of nutrient foramina located in the middle third of femur along the linea aspera. Thus, linea aspera should not be stripped off during surgical procedures to avoid damage to the nutrient arteries.

Using nutrient foramina to differentiate human from non-human long bone fragments in bioarchaeology and forensic anthropology

Long bone shaft fragments can be found isolated in archaeological and forensic contexts, such as in mass fatality incidents. When diagnostic morphological landmarks are not visible, the assessment of a human or non-human origin of a bone fragment can be challenging. Further methods need to be developed. In long bones, the presence of a nutrient foramen on fragments that do not show any diagnostic landmarks can make the assessment of the origin of the bone still possible. In this paper, human long bones were compared to those of the following species: chicken (Gallus gallus domesticus), duck (Cairina moschata), sheep (Ovis aries), pig (Sus scrofa domesticus), and deer (fallow deer, Dama dama, and roe deer, Capreolus capreolus). Macroscopic evaluation of location, direction and appearance, and micro-CT scanning in order to measure angle and shape of canal entrance, were applied in this study to differentiate human from non-human nutrient foramina on long bone shafts. Observations regarding the location and direction of nutrient foramina were proven to be different between human and non-human bones; however, these two features might not be exploitable in cases of highly fragmented bones. The foramina appearance was the most reliable for the origin identification, although the shape of the canal entrance and its angle at the cortical bone, obtained from micro-CT scans, were also useful parameters. For a correct identification of a fragment, one parameter may not be enough and it is advisable to employ as many features as possible. This research demonstrates that nutrient foramina have potential as a reliable bone feature for the distinction between human and non-human fragmented and incomplete long bones.

Study of Morphometric Variations in the Nutrient Foramina of Fibula in Central Rajasthan

The fibula is located lateral to the tibia in the leg. The fibula is the bone of choice for grafting and to reconstruct large defects after tumor resection, because of its length, biomechanical stability, limited donor site morbidity and predictable vascular pedicle. The objectives of the study are: (1) To locate and describe the position, number & direction of nutrient foramina of fibula. (2) To observe any variations in location, position and number of nutrient foramina of fibula in the present study, observations will be made on the 150 adult dry human fibulae. Variations in the number, location and distribution of nutrient foramen will be observed, analysed and compared with earlier studies by various authors. Variation in the number of nutrient foramen will be accounted. Position of Nutrient foramen will be frequently noted.

Study of diaphyseal nutrient foramina in human long bones.

A study was done to determine the number, size, direction, exact site and position of the nutrient foramina in human long bones. The position of all nutrient foramina observed was on the flexor aspect and was more or less around a fixed area, but the exact spot varied considerably. Two foramina were much more frequent in the femur, clavicle and humerus than in the other long bones. Three and four nutrient foramina have also been observed in few femora, clavicles and ulnae. Absence of a foramen has been observed in few humeri and radii. Variations have been observed in the direction of nutrient foramina only in lower limb bones. The nutrient foramina in long bones have been described as being directed towards the elbow and away from the knee. Our observations support this assumption except in 0.5% femora, 3.5% tibiae and 9.5% fibulae. Periosteal, muscular and vascular theories are discussed for the normal and abnormal direction of the foramina; the vascular theory offers the best explanation of all reported anomalies as well as of the normal fashioning of the nutrient canals.