IJAR.2017.462

Type of Article:  Original Research

Volume 5; Issue 4.3 (December 2017)

Page No.: 4746-4750

DOI: https://dx.doi.org/10.16965/ijar.2017.462

TOPOGRAPHY OF DIAPHYSEAL FORAMINA IN BONES OF UPPER EXTREMITY AND ITS SURGICAL IMPLICATIONS

Saroj Kumar 1, Venkatesh Kamath *2, Muhammed Asif 3, Shivarama Bhat 4, Md. Tabrej Alam 5.

1 Associate Professor, Department of Anatomy, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India.

*2 Associate Professor, Department of Anatomy, G.S.L. Medical College, Rajahmundry, Andhra Pradesh, India.

3 Lecturer, Department of Anatomy, Yenepoya Medical College, Mangalore, Karnataka, India.

4 Professor, Department of Anatomy, Yenepoya Medical College, Mangalore, Karnataka, India.

5 Assistant Professor, Department of Anatomy, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India.

*Corresponding author: Dr. Venkatesh Kamath, Associate Professor, Department of Anatomy, G.S.L. Medical College, NH-16, Lakshmipuram, Rajahmundry, Andhra Pradesh, India 533296.  phone no: 9651710187 E-Mail: drvenkateshkamath@gmail.com

ABSTRACT

Background and aims: The recent developments in the field of bone grafting surgeries make it imperative for a surgeon to understand precisely the topography of the nutrient foramina to ensure procedural success without vascular compromise.

Materials and Methods: The study involved 205 bones, which included 70 humerus, 71 radii and 64 ulnae. The position and number of the primary diaphyseal nutrient foramina in each of the bones was studied.

Results: It was observed that all the bones have a single primary nutrient foramen. The mean foraminal index was 55.41 for humerus, 34.84 for radius and 35.86 for ulna. In the humerus, the primary diaphyseal foramen is usually observed in the middle third of the bone and in the radius and ulna it is observed predominantly in the junction between the upper and middle third. In the humerus the foramen is predominantly seen on the antero-medial surface (95.71%). In the radius and ulna, the primary diaphyseal foramen was predominantly seen on the anterior surface with a 91.54% incidence in radius and 100% incidence in the ulna.

Conclusion: An orthopedic surgeon performing a bone graft or a joint replacement or internal fixation involving precise positioning of plate or a vascularized bone microsurgery must be familiar with the precise location of the nutrient foramen for preserving the vasculature of bone and ensuring good postoperative prognosis.

Key words: bone grafting; foraminal index; nutrient artery; nutrient foramen; surgical implications.

REFERENCES

  1. Lewis OJ. The blood supply of developing long bones with special reference to the metaphyses. J Bone Joint Surg Br. 1956;38-B:928–933.
  2. Sendemir E, Cimen A. Nutrient foramina in the shafts of lower limb long bones: situation and number. Surg Radiol Anat. 1991;13:105-108.
  3. Patake SM, Mysorekar VR. Diaphysial nutrient foramina in human metacarpals and metatarsals. J Anat. 1977;124:299–304.
  4. Taylor GI. Fibular transplantation. In: Serafin D, Bunke HJ (eds), Microsurgical composite tissue transplantation, C.V.Mosby Co., St. Louis, 1979;418-423.
  5. Wavreille G, Dos Remédios C, Chantelot C, Limousin M, Fontaine C. Anatomic bases of vascularized elbow joint harvesting to achieve vascularized allograft. Surg Radiol Anat. 2006;8:498–510.
  6. Longia GS, Ajmani ML, Saxena SK, Thomas RJ. Study of diaphyseal nutrient foramina in human long bones. Acta Anat. 1980;107:399–406.
  7. Gümüsburun E, Yücel F, Ozkan Y, Akgün Z. A study of the nutrient foramina of lower limb long bones. Surg Radiol Anat. 1994;16:409–412.
  8. Kirschner MH, Menck J, Hennerbichler A, Gaber O, Hofmann GO. Importance of arterial blood supply to the femur and tibia for transplantation of vascularized femoral diaphyses and knee joints. World J Surg 1998;22:845–852.
  9. 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.
  10. 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. J. Morphol. 2011;29:514-520.
  11. Forriol Campos F, Gomez Pellico L, Gianonatti Alias M, Fernandez-Valencia R. A study of the nutrient foramina in human long bones, Surg Radiol Anat. 1987;9:251–255.
  12. Lee JH, Ehara S, Tamakawa Y, Horiguchi M. Nutrient canal of the fibula. Skeletal Radiol. 2000;29:22-6.
  13. Hughes H. The factors determining the direction of the canal for the nutrient artery in the long bones of mammals and birds. Acta Anat (Basel). 1952;15:261–280.
  14. Ukoha UU, Umeasalugo KE, Nzeako HC, Ezejindu DN, Ejimofor OC, Obazie IF. A study of nutrient foramina in long bones of Nigerians. National journal of medical research. 2013;3:304-308.
  15. Payton CG. The position of the nutrient foramen and direction of the nutrient canal in the long bones of the madder-fed pig, J Anat. 1934;68(Pt 4):500–510.
  16. Mysorekar VR, Diaphysial nutrient foramina in human long bones, J Anat, 1967;101(Pt 4):813–822.
  17. Giebel GD, Meyer Ch, Koebke J, Giebel G, Arterial supply of forearm bones and its importance for the operative treatment of fractures, Surg Radiol Anat. 1997;19(3):149–153.
  18. Murlimanju BV, Prashanth KU, Prabhu LV, Kumar CG, Pai MM, Dhananjaya KVN. Morphological and topographical anatomy of nutrient foramina in the lower limb long bones and its clinical importance. AMJ. 2011;4:530-537.

Cite this article: Saroj Kumar, Venkatesh Kamath, Muhammed Asif, Shivarama Bhat, Md. Tabrej Alam. TOPOGRAPHY OF DIAPHYSEAL FORAMINA IN BONES OF UPPER EXTREMITY AND ITS SURGICAL IMPLICATIONS. Int J Anat Res 2017;5(4.3):4746-4750. DOI: 10.16965/ijar.2017.462