Analytical and morphometric study of nutrient foramina of femur and its clinical implications

Authors

  • Lejla Dervisevic Department of Anatomy, Medical faculty University of Sarajevo, Sarajevo, Bosnia and Herzegovina http://orcid.org/0000-0003-1050-3384
  • Amela Dervisevic Department of Human Physiology, Medical faculty University of Sarajevo, Sarajevo, Bosnia and Herzegovina
  • Zurifa Ajanovic Department of Anatomy, Medical faculty University of Sarajevo, Sarajevo, Bosnia and Herzegovina
  • Ilvana Hasanbegovic Department of Anatomy, Medical faculty University of Sarajevo, Sarajevo, Bosnia and Herzegovina

DOI:

https://doi.org/10.18203/2320-6012.ijrms20191347

Keywords:

Femur, Nutrient foramen, Topography, Vascularization

Abstract

Background: The femur is supplied princially by the diaphyseal nutrient artery which enters the bone throught the nutrient foramen. This supply is essential during the growing period, the early phases of ossification, and in different surgical procedures. The aim of present study was to examine the morphology and topography of the femur nutrient foramen to provide detalied data on such features.

Methods: This was a cross-sectional-descriptive study in which we observed 50 femurs. We analysed the number and location of nutrient foramina, the length of the bone, the position of the nutrient foramen regarding to values of FI, correlation between number of nutrient foramen and length of femur, correlation between position of nutrient foramen and side of extremity to which femur belongs.

Results: The double foramina were common in right (57.1%) and left (42.1%) femur, mostly located in medial lip of aspera line in right (64.3%) and on the lateral lip in left femur (68.4%), with statistically significant correlation, χ = 4.85; p = 0.03, p <0.05.  The foramina in left (89.5%) and right (96.4%) femur were commonly observed at their middle third, with no statistically significant correlation between position of foramen accordingly to Foraminal Index value and side of extremity on which femur belongs (p=0.56; p>0.05). There is positive correlation between length of right and left femur and number of foramina.

Conclusions: The study provides data of the nutrient foramina on femur, which is helpful for clinicians to help preserve bone vascularization during surgery.

References

Somayaji KS, Rao MK. Pregled značaja maksilofacijalne anatomije u endodonciji. Acta stomatologica Naissi. 2012;28(65):1128-43.

Sanudo JR, Vazquez R, Puerta J. Meaning and clinical interests of anatomical variations in the 21th century. Eur J Anat. 2003;7(1):1-3.

Vinay G, Kumar A. A study of nutrient foramina in long bones od upper limb. Anatomica Karnataka. 2011;5(3):53-6.

Lewis OJ. The blood supply of developing long bones with special reference to the metaphyses. J Bone Jt Surg. 1956;38:928-33.

Rhinelander FW. The normal microcirculation of diaphyseal cortex and its response to fracture. J Bone Joint Surg. 1927;50A:643-62.

Skawina A, Litwin JA, Gorzyca J, Miodonski AJ. The vascular system of human fetal long bones: A scanning electron microscope study of corrosion casts. J. Anat. 1994;185:369-7.

Mladenović D, Mitković M, Golubović Z, Radenković M, Micić I, Karaleic Š. Rezultati primene nove biološke metode unutrašnje fiksacije femura po Mitkoviću. Acta Fac Med. NAISS. 2002;19(3-4):245-9.

Caroll SE. A study of Nutrient Foramina of the Humeral Diaphysis. J Bone Joint Surg. 1963;45B:176-81.

Kircher MH, Menck J, Hennerbichler A, Gaber O, Hofmann GO. Importance of arterial blood supply to the femur and tibia for transplantation of vascularized femoral diaphysis and knee joints. World J Surg. 1998;22:845-852.

Kizilkanat E, Boyan N, Esin TO, Soames R, Oguz O. Location, number and clinical significance of nutrient foramina in human long bones. Ann Anat. 2007;189:87-95.

Gopalakrishna K, Rathna BS. The study on the incidence and direction of nutrient foramen in the diaphysis of femur bone of south Indian origin and their clinical importance. Int J Basic Life Sci. 2014;2(2):11-9.

Longia GS, Ajmani ML, Saxena SK, Thomas RJ. Study of diaphyseal nutrient foramina in human long bones. Acta Anat (Basel). 1980;107(4):399-406.

Collipal E, Vargas R, Parra X, Silva H, Del Sol M. Diaphyseal nutrient foramina in the femur, tibia and fibula bones. Int J Morphol. 2007;25(2):305-8.

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;68:500-10.

Nagel A. The clinical significance of the nutrient artery. Orthop. 1993;22:557-61.

Kumar R, Mandloi RS, Singh AK, Kumar D, Mahato R. Analytical and morphometric study of nutrient foramina of femur in Rohilkhand region. Inovative J Med Heal Sci. 2013;3(2):52-4.

Forriol Campos F, Pellico LG, Aliasn MG, Fernandez Valencia R. A study of the nutrient foramina in human long bones. Surg Radiol Anat. 1987;9:251-5.

Mysorekar VR. Diaphyseal nutrient foramina in human long bones. J Anat. 1967;101:813-22.

Gűműsburun E, Yűcel F, Ozkan Y, Akgűn Z. A study of the nutrient foramina of lower limb long bones. Surg Radiol Anat. 1994;16(4):409-12.

Prashanth K, Murlimanju BV, Prabhu LV, Kumar CG, Pai MM. Morphological and topographical anatomy of nutrient foramina in the lower limb long bones and its clinical importance. Australasian Med J. 2011;4(10):530-537.

Sendemir E, Çimen A. Nutrient foramina in the shaft of lower limb long bones: situation and number. Surg Radiol Anat. 1991;13:105-8.

Trueta J. Blood supply and the rate of healing of tibial fractures. Clin Orthop Rel Res. 1953;105:11-26.

Lutken P. Investigation into the position of the nutrient foramina and direction of the vessels canals in the shaft of the humerus and femur ion man. Acta Anat. 1950;9:57-68.

Laing PG. The blood supply of femoral shaft. J Bone Surg. 1953;35:462-6.

Kumar R, Mandloi RS, Kumar Singh A, Kumar D, Mahato P. Analytical and morphometric study of nutrient foramina of femur in Rohilkhand region. Inovative J Med Heal Sci. 2013; 3:52-54.

Bhatnagar S, Deshwal AK, Tripathi A. Nutrient foramina in the upper and lower limb long bones: A morphometric study in bones of Western Uttar Pardesh. IJSR. 2014;3(1):301-3.

Downloads

Published

2019-03-27

How to Cite

Dervisevic, L., Dervisevic, A., Ajanovic, Z., & Hasanbegovic, I. (2019). Analytical and morphometric study of nutrient foramina of femur and its clinical implications. International Journal of Research in Medical Sciences, 7(4), 1324–1329. https://doi.org/10.18203/2320-6012.ijrms20191347

Issue

Section

Original Research Articles