A Study On Nutrient Foramen Of Humeri And Its Clinical Significance

ABSTRACT

Background: A Nutrient Foramen [NF] or vascular channel is a small tunnel in cortex of long bones which is apathway for the entry of nutrient artery. Nutrient artery has pivotal contribution of blood supply to long bonesand plays a major role in Orthopaedic Surgical procedures like bone transplantation, bone grafting thus avoidingavascular necrosis of fractured bonesAims: To determine morphological parameters (variation in number, location, direction) and morphometricparameters (variation in size and foraminal index [FI] ) of nutrient foramina in Humeri.Materials and methods: Present study was conducted on a total of 80 dried human adult Humeri of either sexesor sides which were obtained from fellow students and Department of Anatomy of ESIC medical college &PGIMSR, Bangalore. Infantometer was used to calculate length of humeri, hand held lens was used to detectnutrient foramen under adequate illumination. Hypodermic needles [18G to 26G, where G is gauge], were used tomeasure the size of NF. Foraminal index was also calculated.Results: In our study mean length of humerus was 29.95cm.FI ranged from 39.34 -81.02.Majority (62.50%) ofhumeri have one NF, (28.75%) have two NF,(7.5%) with three nutrient foramina and (1.25%) had no NF. Majority ofNF (43.43%) were present on antero-medial surface, (37.37%) on medial border, (14.14%) on posterior surface,(2.02%) on both anterolateral surface and anterior border, 1.01% in lateral border. (90.09%) of NF were locatedin Zone II (middle third), (8.08%) in Zone III (lower third) and (1.01%) in zone I (Upper third). Majority (41.41%)were of large gauge, (34.34%) of medium gauge and (24.24%) of small gauge. All NF directed towards distal endof humerus.Conclusion: For healing of fractures, blood supply plays a vital role. Awareness about variations in NF isimportant because damage to nutrient artery due to any cause like trauma, road traffic accidents will causeinadequate blood supply .Thus vascular and bone transplant surgeons can reconstruct damaged artery andavoid ischemia of graft during open reduction procedures and transplant surgeries.