A Study on Variations of Nutrient Foramen of Humerus With Its Clinical Implications

Abstract

Background: Nutrient foramen is an opening into shaft of humerus 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. Lack of an adequate vascular supply can significantly delay or prevent fracture healing. Nutrient artery is the major source of blood supply to the long bone and hence plays an important role in fracture healing.Objective: The nutrient foramens obey the rule of ossification, that is directed away from the growing end of the bone or not. Materials and Methods:The present study consisted of 68 (34 right and 34 left) dried humeurus excluding any fracture or pathological abnormalities. Number and direction of nutrient foramen was observed in each humerus. Location of nutrient foramen in relation with surfaces and zones of humeurus was determined.Result: It has been observed that 94.12% of the humerus had a single nutrient foramen, 6.39% double foramen, all humerus have nutrient foramina. It was concluded that the majority (73.61%) of the nutrient foramina were present on the antero-medial surface, 8.33% on the anterolateral surface and 8.33% on the posterior surface of the shaft of humerus and 8.33% of nutrient foramina present on anterior border. It was also concluded that most (86.11%) of the foramina present in the zone II followed by zone I (8.33%) then by zone III (5.56%). All foramina were directed toward the lower end of humerus. Conclusion:By knowing the number and location of the nutrient foramina in humerus 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.

An Investigation of the Nutrient Foramen in the Long Bones of the Upper and Lower Limbs in Turkish Population

“…Similar to the results in the literature, in the present study, the NF in the clavicle was mostly directed toward the acromial end (12). It has been reported that NF in the humerus is mostly directed distally (7,(22)(23)(24)(25). The current study, it was observed that the NF in the humerus was mostly directed distally, while there was also NF directed proximally.…”

“…In the radius we examined, the most common anatomical location of NF was on the anterior surface, similar to the results of other studies. We encountered the NF also in the interosseous border in the current study, differently from the literature (7,27). In the ulna we examined, the most common anatomic location of the NF was the anterior surface, as in previous studies (20,(24)(25)(26).…”

“…Upon examining the FI value, as in the literature, the foramen with an FI value of 0-33.33% was accepted to be localized in the proximal 1/3 of the bone (in the medial 1/3 in the clavicle), the foramen with an FI value of 33.33-66.66% was accepted to be localized in the middle 1/3 of the bone, the foramen with an FI value of 66.66-100% was accepted to be localized in the distal 1/3 of the bone (in the lateral 1/3 in the clavicle) (1,7,8).…”