Morphometric Study of the Nutrient Foramen of the Humerus in the Population of Bihar

Abstract

Introduction: Fracture or surgical intervention of fracture of the shaft of the humerus may cause injury to the nutrient artery leading to the nonunion or delayed union of the fracture. It is important to find the number and location of the nutrient artery. So the knowledge regarding the nutrient foramen helps to protect them during any operative procedure of the shaft of the humerus. The main objective of this study is to find out the number, location, and direction of the nutrient foramen of the humerus.Materials and methods: The study was conducted on 80 dried humeri of unknown gender obtained from Narayan Medical College, Sasaram, Bihar, India, and also from other medical colleges of Bihar. The number, location, and direction of nutrient foramen were observed.Results: The majority of humeri showed one nutrient foramen, which was found in 91.25%, followed by 3.75% with double foramen and 1.25% with triple foramen. Nutrient foramen was absent in 3.75% of the humerus. The majority (89.02%) of nutrient foramen was found on the anteromedial surface followed by anterolateral (9.76%) and posterior surface (1.22%). The majority of nutrient foramen was found on the middle third (86.58%) of the shaft, followed by 13.42% on the distal third. No nutrient foramen was found on the proximal third of the humerus. All nutrient foramina were directed downward. Conclusion:The location of the nutrient foramen of the humerus was not constant; it may present on anteromedial, anterolateral, or posterior surfaces. Similarly, it may present on the middle or distal third of the shaft of the humerus. This study will help surgeons planning the surgical intervention of the shaft of the humerus, which will possibly reduce the chances of nonunion or delayed union.

A Study on Diaphyseal Nutrient Foramen of Humerus

“…The mean TL was measured as 301.68±20.61 mm in our study which is similar to the studies of Cihan and Toma [10] in Türkiye (right: 304.39±20.04 mm, left: 303.54±20.22 mm), Kumar et al. [20] in India (301.1±19.4 mm), Öztürk et al [11] in Türkiye (311.33±30.9 mm), Arfan et al [13] in India (304.22±21.98 mm), Desai and Damor [14] in India (right: 300.8±17.8 mm, left: 302.3±20.8 mm) and higher than the studies of Mansur et al [16] in Nepal (270.22 mm) and Poudel and Satyal [18] al. [13] (56.83±7.80%) and higher than that of Öztürk et al [11] (52.39±14.84%), Poudel and Satyal [18] (48.12%), and Desai and Damor [14] (right: 53.27%, left: 49.96%).…”

“…[16], Singh et al [1], Cihan and Toma [10] and Kumar et al [20] no NF was detected on the anterior border, as is the case in our study. No NF was observed to be located on the anterolateral surface and lateral border by Öztürk et al [11], and Ehab Kamal Ali [15] and Mansur et al [16] have not observed any NF on the medial and lateral border, and no NF was observed on the lateral border according to the study by Arfan et al [13] (Table 3.…”

“…Cihan and Toma [10] in Türkiye 59 (57.28%) and higher in the study by Kumar et al [20] in India 73 (91.25%) compared to our study. The present study showed that no NF was detected on 9 (7.96%) of the humeri, which was similar to the findings of Desai no humerus with more than 3 foramina was observed (Table 3.…”

“…NFs are usually localized in the middle 1/3 of the humerus, there may also be NFs localized on the proximal 1/3 and distal 1/3 [1,10,11,13,14,16]. Unlike other studies, no NF was detected on the proximal 1/3 of the humerus in the studies performed by Poudel and Satyal [18], Kumar et al [20] and Cihan and Toma…”

“…Initially, NFs were defined using a magnifying glass on the surfaces and borders of the humerus, number, and direction (towards the proximally, distally and horizontally) of the NFs were recorded. Size of the NFs were evaluated respectively by 14,16,18,20,22, and 24 gauge sized hypodermic needles, and which needle fits the foramens's diameter was determined; the needle with the accurate gauge size was noted as size of examined NF. We evaluated diaphyseal NFs on the humerus, epiphyseal NFs were excluded from the study.…”