Anatomical and Morphological Study of Nutrient Foramen in Leg Bones

Nutrient Foramen in Leg Bones

Abstract

Introduction: Knowledge of position of nutrient foramina of long bones can be useful in certain surgical procedures. Bone ossification, growth and healing depend on its vascularity. Nutrient artery is the main source of blood supply of bone along with periosteal arteries. The topographical knowledge of these foramina is useful in certain operative procedures, in orthopedics as well as in plastic and reconstructive surgeries.AIM: The present study aims to determine the number and position of nutrient foramen of tibia and fibula and to observe direction and obliquity of nutrient foramina. Subjects and Methods: 100 adult dry bones including 50 tibia and 50 fibula were studied. Nutrient foramina were identified with naked eyes. The obliquity was determined with hypodermic needle. The nutrient foramina location was determined by dividing total bone into segments, the locations were validated by calculating foraminal index. Results: It has been observed that 98% (49) tibia has single nutrient foramina, double nutrient foramiana present in 2%of tibia. Most of the nutrient foramina in tibia are present in upper third i.e 65%(33).Foramina index of tibia is 45.05 with standard deviation of 8.29.In fibula single foramen  was observed in 46(92%) and double foramina 2(4) and there is no nutrient foramen in 2(4). In 2 fibulae having double nutrient foramen, proximal foramen was directed downward and distal foramen was directed upwards. In 50%(25) nutrient foramina is present in posterior surface,most of nutrient are in middle third 48(96%).mean foraminal index of fibula is 45.05 with standard deviation  of 8.29. Conclusion: Our study has attempted to put together findings from different studies regarding the number and position  and obliquity of nutrient foramina of leg bones .The present study will be useful for orthopedic surgeons during procedures like bone grafting and more recently microsurgical vascularised bone transplantation and new graduates to understand the importance of nutrient foramina of long bones.