IJAR.2018.410

Type of Article:  Original

Volume 7; Issue 1.2 (February 2019)

Page No.: 6132-6137

DOI: https://dx.doi.org/10.16965/ijar.2018.410

A STUDY ON VARIATIONS OF NUTRIENT FORAMEN OF HUMERUS WITH ITS CLINICAL IMPLICATIONS

Aashish J Rathwa 1, Sanjay R Chavda *2.

1 Tutor, Department of Anatomy, P.D.U. Medical College, Rajkot, Gujarat, India.

*2 Assistant Professor, Department of Anatomy, P.D.U. Medical College,  Rajkot, Gujarat, India.

Address for correspondence:  Dr. Sanjay R Chavda, Assistant Professor, Department of Anatomy, P.D.U. Medical College, Rajkot – 360001, Gujarat, India. Mobile No: 8866385680 E-Mail: drsanjay1409@gmail.com

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.

KEY WORDS: Clinical implications, Foraminal index, Humerus, Nutrient foramen.

REFERENCES

  1. Krishna Garg. BD Chaurasia’s Hand Book of General Anatomy. Blood supply of bones. 4th ed. 2011. CBS Publishers and Distributors Pvt. Ltd:43-44.
  2. Longia GS, Ajmani ML, Saxena SK, Thomas RJ. Study of diaphyseal nutrient foramina in human long bones. Acta Anat. 1980;107:399- 406.
  3. Sendemir E, Cimen A. Nutrient foramina in the shafts of lower limb long bones: situation and number.Surg Radiol Anat. 1991; 13:105-8.
  4. Standring S.Gray’s Anatomy, 40th ed. CHURCHILL LIVINGSTONE ELSEVER, 2008:798.
  5. Bokariya P, Gudadhe D, Kothari R, Murkey PN, Shende MR. Comparison of humerus and femur with respect to location and number of nutrient foramina. Indian Journal of Forensic Medicine and Pathology. 2012;5(2):79-81.
  6. Henderson RG. The position of the nutrient foramen in the growing tibia and femur of the rat. J Anat. 1978; 125(3):593-9.
  7. Mysorekar VR. Diaphysial nutrient foramina in human long bones. J Anat. 1967;101(4):813–22.
  8. Nagel A. The clinical significance of the nutrient artery. Orthop Rev 1993; 22:557-61
  9. Dyankova S. Vascular anatomy of the radius and ulna diaphyses in their reconstructive surgery. Acta Chir Plast 2004; 46:105-9.
  10. Choi SW, Kim HJ, Koh KS, Chung IH, Cha IH. Topographical anatomy of the fibula and peroneal artery in Koreans. Int J Oral Maxillofac Surg 2001;30:329-32.
  11. Schiessel A, Zweymuller K. The nutrient artery canal of the femur: a radiological study in patients with primary total hip replacement. Skeletal Radiol 2004;33:142-9.
  12. Hughes H. The factors determining the direction of canal for the nutrient artery in the long bones of mammals and birds. Acta Anatomica. 1952; 15(3): 261-280.
  13. Joshi H, Doshi B, Malukar O. A study of the nutrient foramina of the humeral diaphysis. NJIRM 2011;2:14-17.
  14. Hoy WE, Hughson MD, Bertram JF, Douglas-Denton R, Amann K. Nephron number, hypertension, renaldisease, and renal failure. J Am Soc Nephrol. 2005;16(9):2557–64.
  15. Sharma M, Prashar R, Sharma T, Wadhwa A. Morphological Variations of Nutrient Foramina in upper limb long bones. Int J Med and Dent Sci. 2013;2(2):177-81.
  16. Pereira GAM, Lopes PTC, Santos AMPV, Silveira FHS. Nutrient foramina in the upper and lower limb long bones: Morphometric study in bones of southern Brazilian adults. Int J Morph. 2011;29(2):514-20.
  17. Bhatnagar S, Deshwal AK, Tripathi A. Nutrient foramina in the upper and lower limb long bones: A morphometric study in bones of western Uttar Pardesh. Int J Sci Res. 2014;3(1):301-3.
  18. Forriol FC, Gomez LP, Gianonatti MA, Fernandez RV. A study of the nutrient foramina in human long bones. Surg Radiol Anat. 1987;9: 251-5.
  19. Shaheen SY. Diaphyseal nutrient foramina in human upper and lower limb long bones. A thesis submitted for the partial fulfillment of the requirement for the master degree in anatomy. 2009:20-21.
  20. Carroll SE. A study of the nutrient foramina of the humeral diaphysis. J Bone Joint Surg. 1963; 45: 176–181.
  21. Solanke KS, Bhatnagar R, Pokhrel R. The number and position of nutrient foramina in humerus, radius, ulna of human dry bones of Indian origin with clinical correlation. OA. 2014;2(1):1-8.
  22. Halagatti MS, Rangasubhe P. A study of nutrient foramina in dry adult humerii of south Indian subjects. NJCA. 2011;1(2):76-80.
  23. Gopalakrishna K, Sreekala MA, Rathna BS. A study on the incidence and direction of nutrient foramina in south Indian humeral diaphysis and their clinical importance. J Med Heal Sci. 2013;3(1):71-6.
  24. Yaseen S, Nitya W, Ravinder M. Morphological and topographical study of nutrient foramina in adult humerii. Int J Innov Res Sci Eng Technol. 2014;3(4):7-10.
  25. Khan AS, Shah Z, Inayat Q. Anatomical variations in diaphyseal nutrient foramina of humerus in cadavers from khyber pakhtunkhwa, pakistan. Khyber Med Univ J. 2014;6(1):18-21.
  26. Vinay G, Kumar AS. A study of nutrient foramina in long bones of upper limb. Anat Karnataka. 2011;5(3):53-6.
  27. Ukoha UU, Umeasalugo KE, Nzeako HC, Ezejindu DN, Ejimofor OC, Obazie IF. A study of nutrient foramina in long bones of Nigerians. Natl J Med 2013;3(4):304-8.
  28. Anusha P, Naidu MP. A study on the nutrient foramina of long bones. Jour of Med Sci and Tech. 2013;2(3):150-7.
  29. Kizilkanat E, Boyan N, Ozsahin ET, Soames R, Oguz O. Location, number and clinical significance of nutrient foramina in human long bones. Ann Anat. 2007;189:87-95.
  30. Kumar S, Kathiresan K, Gowda MST, Nagalaxmi. Study of diaphyseal nutrient foramina in human long bones. Anat Karnataka.2012;6(2): 66-70.
  31. Berard A. Memoirs Sur Ie Rapport Qui Existe Entre La Direction Des Conduits Nourriciers Des Os Longs, Et I’ordre Suivant Lequelles Epiphyses Se Soudent Au Corps De I’os. Arch Gen Med Series.1835; 27:176-183.
  32. Datta AK. Essentials of Human Osteology: General Consideration. 2nd ed. Kolkata. Current Books International 1997:5.
  33. Chandrasekaran S, Shanthi KC. A study on the nutrient foramina of adult humerii. J Clin Diagn Res. 2013;7(6):975-7.
  34. Parmar AMB, Vaghela B, Shah K, Patel B, Tridevi B. Morphometric analysis of nutrient foramina in human typical long bones of upper limb. Natl J Integr Res Med. 2014;5(5):26-9.
  35. Murlimanju BV, Prashanth KU, Prabhu LV, Saralaya VV, Pai MM, Rai R. Morphological and topographical anatomy of nutrient foramina in human upper limb long bones and their surgical importance. Rom J Morphol Embryol 2011;52(3):859–62.

Cite this article: Aashish J Rathwa, Sanjay R Chavda. A STUDY ON VARIATIONS OF NUTRIENT FORAMEN OF HUMERUS WITH ITS CLINICAL IMPLICATIONS. Int J Anat Res 2019;7(1.2):6132-6137. DOI: 10.16965/ijar.2018.410