International Journal of Anatomy and Research

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Type of Article: Original Research

Year: 2016 | Volume 4 | Issue 3 | Page No. 2684-2688

Date of Publication: 31-08-2016



Swapna A. Ambekar *1, Shivaji B. Sukre 2.

*1 Associate Professor, Department of Anatomy, Government Medical College & Hospital, Aurangabad, Maharashtra, India.

2 Professor & HOD, Department of Anatomy, Government Medical College & Hospital, Aurangabad, Maharashtra, India.

Address: Dr. Swapna A Ambekar, 64 Sarang society (Above Axis Bank), Gajanan Maharaj Mandir Road, Garkheda Parisar Aurangabad 431005, Maharashtra, India. Phone: +91-9822646424


Background: The nutrient foramen (NF) is the largest of the foramen present on the shaft of long bone allowing nutrient artery to enter the bone. These arteries are important during active growth period of embryo and fetus and during the early phases of ossification. They provide 70–80% of the interosseous blood to long bones.
The context and purpose of the study: The study was conducted on 156 long bones of lower limb available in the department of anatomy, Government medical college, Aurangabad.
The aim of the study was to note the morphology and variations of nutrient foramen in human adult lower limb long bones and to discuss its clinical importance. We observed only diaphyseal nutrient foramens of these bones for size and number. Size of foramens were measured using hypodermic needle and foramen were classified as secondary (SF) or dominant (DF). Number of foramens or their absence was noted. Distance of nutrient foramen (DNF) was measured using Vernier caliper from highest point of head of femur and fibula to foramen and from center of tibial condyles on posterior aspect of tibia. Total length of bone (TL) was measured using standard osteometric board. The location of all nutrient foramen in upper, middle or lower third of bone was determined by calculating a foraminal index using Hughes formula.
Results: We observed that maximum tibia had single foramen followed by fibula and femur. We found maximum five foramens on two left femurs. One femur had secondary foramen on anterior surface. Nutrient foramens were totally absent in six fibulas. According to foraminal index, tibia had maximum nutrient foramen in upper third of shaft while femur and fibula had them on lower third.
Potential implications: On radiograph, nutrient foramen mimics longitudinal stress fracture or may be misdiagnosed as lytic bone lesions like osteoid osteoma. Precise knowledge of nutrient foramen and its variations is necessary for doctors to predict prognosis of grafts, tumors, fractures of bones and also useful for anthropologist during interpretation of height from a fragment of bone.
Conclusions: The maximally observed position of nutrient foramen is in middle third of the shaft of femur and fibula while upper third of shaft in tibia. Knowledge of which is important clinically for proper diagnosis and planning of surgery and also to predict the prognosis.
Key words: Secondary Or Dominant Foramen, Foraminal Index, Longitudinal Stress Fracture.


  1. Standring S, Collins P, Wigley C., Introduction and systemic overview, Grey’s Anatomy, Anatomical basis of clinical Practice 39th edition, London: Elsevier Churchill Livingstone 2005:93-96.
  2. Sharma M, Prashar R, Sharma T, Wadhwa A, Kaur J. Morphological variations of nutrient foramina in lower limb long bones. Int J Med and Dent Sci 2015;4(2):802-808.
  3. Udhaya K., Devi K.V., Sridhar J., Analysis Of Nutrient Foramen Of Tibia-South Indian Population Study Int J Cur Res Rev, April 2013;05(08):91-98.
  4. Craig, J.G., Widman, D., van Holsbeeck, M., Longitudinal stress fracture: patterns of edema and the importance of the nutrient foramen. Skeletal Radiol. 2003;32:22-27.
  5. Longia GS, Ajmani ML, Saxena SK, Thomas RJ, Study of diaphyseal nutrient foramina in human long bones, ActaAnat (Basel), 1980;107(4):399–406.
  6. Bodor Daniel, Longitudinal Stress Fracture MRI Web Clinic — March 2008 assessed on 12 march 2016.
  7. Saad J., Zrig A.  Marrakchi F, Harbi F., Alghamdi S.  Longitudinal Stress Fracture: Patterns Of Edema And The Importance Of The Nutrient Foramen In MRI Evaluation.   European society of radiology 2015;1-17
  8. Rawson C, Robinson J. Rare anterior nutrient foramen of the tibia in an adolescent with shin pain. Radiology Case Reports. (Online) 2015;10(2);1018.
  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(1):87-95.
  10. Kumar R, Mandloi R.S., Singh A. K. Kumar  D etal  Analytical And Morphometric Study Of Nutrient Foramina Of Femur In Rohilkhand Region, Innovative Journal of Medical and Health Science 2013;3:52-54.
  11. Mazengenya P. and Fasemore M.D., Morphometric studies of the nutrient foramen in lower limb long bones of adult black and white South Africans Eur. J. Anat. 2015;19(2):155-163.
  12. Gupta R. K., Gupta A.K. A Study Of Diaphyseal Nutrient Foramina In Human Tibia, National Journal Of Medical Research Oct – Dec 2014;4(4):310:13.


Swapna A. Ambekar, Shivaji B. Sukre. DIAPHYSEAL NUTRIENT FORAMEN OF LOWER LIMB LONG BONES: VARIATIONS AND IMPORTANCE. Int J Anat Res 2016;4(3):2684-2688. DOI: 10.16965/ijar.2016.306




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