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

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.