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Background: The humerus, being the largest bone of the upper limb, relies on a well-established blood supply system for its nourishment and healing processes, particularly in cases of fractures. The presence and characteristics of the nutrient foramen play a crucial role in determining the effectiveness of orthopedic surgical interventions and the healing outcome of fractured bones. Understanding the quantitative and qualitative aspects of the nutrient foramen in the humerus is essential for orthopedic surgeons to minimize the risk of vascular injury during surgical procedures and optimize fracture healing. Methods: This analytical observational study examined 160 dry humeri (80 right and 80 left) of unknown genders obtained from the anatomy department of a medical college over a three-year period. Bones with previous damage, healed fractures, congenital anomalies, and significant pathological changes were excluded. The nutrient foramina were identified, and their quantity, position, location, and orientation were examined using magnification. The foraminal index (FI) was calculated to determine the location of the nutrient foramen relative to different segments of the humerus. Osteometric measurements were conducted using appropriate tools, and statistical analysis was performed using Microsoft Excel. Results: The majority (91.25%) of humeri exhibited a solitary nutrient foramen, while a small percentage displayed two (3.75%) or three (1.25%) foramina. Most nutrient foramina were located on the anteromedial surface (89.02%) of the humerus, primarily in the middle one-third segment (86.58%). The mean total length of the humerus was approximately 30.11 cm, with the nutrient foramina situated at an average distance of 16.65 cm from the proximal end. The consistent foraminal index (55.53%) indicated a uniform distribution pattern of nutrient foramina along the length of the humerus. Conclusion: This study provides valuable insights into the quantity, orientation, and position of the nutrient foramen in the humerus. The findings underscore the importance of understanding the vascular anatomy of the humerus for orthopedic surgical planning and fracture management. Orthopedic surgeons can use this knowledge to minimize the risk of vascular injury during surgical procedures and optimize fracture healing outcomes, ultimately improving patient care and treatment efficacy. [ABSTRACT FROM AUTHOR]

Background: The nutrient foramina are cavities contain nutrient arteries and peripheral nerves. The present study was done in Department of Anatomy, L.N. Medical College and Research Centre, Bhopal with 100 dry human femurs. there were 149 foramina in 100 femurs. Mean length of femur 435mm, most frequently seen on Linea aspera of femur foramina index mean was 44.3403 for femur. Right side femur foramina index range 28.52-63.86, left side bone foramina index range 30.65-61.42. Information about number, location, position and direction of nutrient foramina important clinically in orthopedic procedures such as joint replacement therapy, fracture repair and preserving blood supply of graft during vascularized bone grafting. [ABSTRACT FROM AUTHOR]

Blood supply is vital for sound callus formation. The tibial nutrient artery (TNA) is the main diaphyseal artery nurturing the tibial shaft. The objective is to investigate the impact of TNA canal (TNAC) injury on the development of atrophic, oligotrophic, and hypertrophic nonunion in patients with tibial shaft fractures. Between January 2010 and December 2020, patients with a nonunion of a tibial shaft fracture were retrospectively included. Two readers independently evaluated the integrity of the TNAC and classified nonunion type. A multinomial regression model was utilized to evaluate if a TNAC injury has an impact on the type of nonunion. From an initial set of 385 patients with the diagnosis of a nonunion of the lower leg, a total of 60 patients could be finally included in the study. Most patients were males (78%), diabetic (95%), smokers (73%), and had an American Society of Anesthesiologists (ASA) score of 2 (72%). TNAC injury was noted in 24 patients (40%): an iatrogenic TNAC injury was observed in 13 (22%) patients, a traumatic TNAC injury in 11 (18%) patients. Most patients had a hypertrophic nonunion (29 patients (48%)), followed by an oligotrophic nonunion (24 patients (40%)) and lastly an atrophic nonunion (seven patients (11%)). The multinomial regression model showed that there was no impact of TNAC injury on the development of a specific type of non-union (p = 0.798 for oligotrophic vs. atrophic nonunion; p = 0.943 for hypertrophic vs. atrophic nonunion). Furthermore, patients were about four times more likely to develop an oligotrophic/hypertrophic nonunion rather than atrophic one (odds ratio 3.75 and 4.25, respectively), regardless of the presence of a TNAC injury. In the evaluated patient cohort with tibial shaft fractures, we could not find a statistically significant association between TNAC injury and type of nonunion. However, patients were almost four times more likely to develop oligotrophic or hypertrophic nonunion rather than an atrophic one although common risk factors for impaired (micro)vascular blood supply were highly prevalent in the study group. Multicenter studies with a larger number of atrophic nonunions are warranted to further evaluate this result. [ABSTRACT FROM AUTHOR]

Background. The fibula is a long bone located at the lateral aspect of the leg. Diaphysis of fibula is supplied by one or more nutrient arteries through an opening referred to as the nutrient foramen. Morphometric studies of the nutrient foramina of fibulae are very sparse in literature. Materials and Methods. This cross-sectional descriptive study was conducted on 51 dry adult human fibulae housed in the department of anatomy, AIIMS, New Delhi. Total fibular length along with the number and location of all nutrient foramina present were recorded. Foraminal indexes (FI) of the fibulae were calculated as well. Results. The study revealed that the average length of fibulae was 35.48 ± 1.76 cm. 94% fibulae had a single nutrient foramen and 6 % had two. In fibula with single foramen, the most common location was on the medial crest (50%), followed by between medial crest and posterior border (35%), between the medial crest and interosseous border (8%) and on posterior border (6%). Nutrient foramen was located in middle 1/3rd of shaft in 98 % and in inferior 1/3rd of shaft in 2 % of fibulae. The average foraminal index was 44.85 ± 6.67% with a range of 35.7 to 63.8%. Conclusion. Most common location of nutrient foramen in fibula is middle 1/3rd of shaft on the medial crest with dual nutrient foramina in 6% of fibulae. These parameters show variability in different geographical location and population groups. These data may be helpful for anthropologists, forensic experts, radiologists and might guide in harvesting vascularised fibular bone graft. [ABSTRACT FROM AUTHOR]

Back ground: Humerus is the long bone located in the arm. The Nutrient foramen is an opening in the bone shaft. It allows the passage of nutrient artery which gives nourishment to the bone. The nutrient artery is the principal blood supply for long bones. Supratrochlear foramen is a small hole located at the distal epiphysis of the humerus. The supratrochlear foramen communicates the olecranon fossa with the coronoid fossa & is present over the trochlea of lower end of humerus. The main aim of the study is to determine the location, number and direction of nutrient foramen in relation to the growing end of adult humeri and also to observe the morphological features like incidence and shape of the supratrochlear foramen. Material and Methods: A total number 100 adult humeri were used for this study. The bones were observed for direction, location and number of nutrient foramen and incidence and shape of the supra trochlear foramen. The collected data was analyzed by using the SPSS software and the results were tabulated. Results: In the present study 95% of bones have single, 4% have double and 1% have triple nutrient foramina respectively. The location of nutrient foramina is found to be antero- medial surface in majority of the bones 94%, posterior surface in 4%, anterolateral surface in 1% and absent in 1% of bones. The direction of nutrient foramen is towards the elbow joint. In majority of the bones 91% nutrient foramina were located in the mid third of shaft of humerus, 8% in lower third and 1% in upper third. The supra trochlear foramen is seen in 18% of the bones. Among the 18 bones supra trochlear foramen is round in 10 humeri and oval in 8. Conclusion: The chief blood supply to the shaft of humerus is by a nutrient artery passing through the nutrient foramen. The knowledge of the location and direction of nutrient foramen is useful in surgical procedures done over humerus such as open reduction of fracture humerus, in newer transplantation and bone grafting techniques being attempted by orthopedic surgeons. The incidence of supratrochlear foramen is varies from one population to other. Knowing the incidence in this population will be helpful to the orthopedic surgeons and radiologists for operative procedures and diagnosis. [ABSTRACT FROM AUTHOR]

Background: The nutrient foramina are cavities that conduct the nutrient arteries and the peripheral nerves on the shaft of long bones. Long bones receive most of the blood supply from the nutrient arteries. The knowledge about position and number of the nutrient foramen is helpful for medico legal cases, anthropological study and orthopaedic surgeons during different surgical procedures. Aims and Objectives: To determine the topography, direction and number of the nutrient foramina in upper and lower limb long bones in Telangana, India. Materials and Method: This observational cross section study was conducted in the department of anatomy; Medical colleges of Telangana states. The number, direction and site of the foramina were noted in all the long bones. A total of 326 long bones of upper and lower limb were examined. Results: Out of total 326 long bones 165 were from upper limb and 161 were from lower limb. The single solitary nutrient foramina were noted in most of the bones. The site of the foramina was mainly on middle third of shaft (except tibia, foramina mainly in upper third of shaft). Maximum number of foramina was found on femur (94) followed by Humerus (74). Conclusion: The present study provides information on the number, position, and direction of nutrient foramina of the long bones. This may help in surgical procedures and in the interpretation of radiological images. [ABSTRACT FROM AUTHOR]

Introduction: The fibula is very well known amongst the surgeons for their usage in bone grafting. The vascularised bone graft is necessary for successful procedure. The vasculature of the bone graft is maintained by procuring the intact nutrient artery along the donor site of the bone. The nutrient artery enters the shaft of the bone through the nutrient foramen. The topographical study of nutrient foramen in human fibulae will benefit the operating surgeons in the surgical procedures like open reduction fracture of the fibula and bone grafting. Aim: To record the position, location, number and direction of the nutrient foramen of the fibula. Materials and Methods: A descriptive study on 100 human dried fibulae obtained from the Department of Anatomy, Seth GSMC and KEM hospital, Mumbai, Maharashtra, India were done from February 2013 to July 2013. A magnifying hand lens and a thin stiff wire to confirm the number and direction of nutrient foramen were used. The lengths of the fibulae were measured and divided into three equal parts. The position and location were determined by identifying the anatomical position and the side of the fibula. The simple statistical method by calculating frequency (n) and percentages (%) in all categories and sub-categories of the collected data was applied to the study. Results: In 17.24% of fibulae the foramen was directed towards the growing end. In 7% of fibulae, there was no foramen, 23% fibulae were having two foramina, and 70% were having one foramen. The nutrient foramen was located maximally on the posterior surface of the fibula (84.48%) and in the middle onethird (81.03%). Conclusion: This study has provided information on the topography of nutrient foramen of the fibula. This knowledge will be useful in certain surgical procedures to preserve the vascularity of fibula.

Introduction: Main source of nutrition to long bone during growth and ossification is nutrient artery. Nutrient canal opens as nutrient foramen on the surface of shaft which conducts the nutrient artery and the peripheral nerves to bones. Nutrient artery provides more than 60-70% of blood supply to long bone, 30- 40% through periosteal, metaphyseal and epiphyseal blood vessels. Aim: To determine number of nutrient foramina, its position on surface of shaft, size and direction of nutrient foramina either towards proximal end or distal end and find out foraminal index from the position of nutrient foramina. Materials And Methods: A cross-sectional study was performed in 177 dry bones (60 humerus, 60 radius, 57 ulna) of upper limb, available at Anatomy Department, GMERS Medical College Himmatnagar, during September 2021. All bones were observed for number, position and direction of nutrient foramina. Size of foramen was measured by needles of different size. Mean Foraminal index was calculated for each long bone of upper limb by using Epi Info™ for windows, CDC, Atlanta, version 7.2. Results: Majority of bones had single nutrient foramina, all foramina were directed towards the elbow joint. All nutrient foramina were on flexor surfaces of bone, except one bone (radius). Majority of nutrient foramina were situated on middle 3rd of the shaft. Size of nutrient foramen was range from 22 to 28 gauge of needle. Conclusion: Information on nutrient foramina of long bones of upper limb will be useful in many orthopedic surgeries like microvascular bone grafting and many plastic reconstructive surgeries. During surgeries like fracture repair, bone graft or muscle graft care should be taken, not to damage these nutrient vessels to keep intact blood supply of bone.

Introduction: Long bones receive its primary blood supply from the nutrient arteries. They are transmitted through oblique canals, called nutrient foramina, into its diaphysis. Knowledge of foraminal topography helps to preserve bone vascularity during surgeries. Aim: To estimate the morphometric and topographic characteristics of diaphyseal nutrient foramina of fibula. Materials and Methods: A descriptive osteometric and morphological assessment of 50 dry fibulae of unknown age and sex were done. The samples were obtained from the Department of Anatomy, Kanyakumari Government Medical College, Asaripallam, Tamil Nadu, India. The length of each bone was measured directly using a measuring tape. Number, location and the direction of nutrient foramina were observed and the data were presented in a tabulated format. Results: The mean height of the fibula on the right side was 35.86±2.441 cm, whereas on the left was 36.64±2.537 cm. It was observed that 92% of the right and 96% of the left bones presented a single foramen. The nutrient foramina were predominately present on the posterior surface of the middle third of the shaft and were directed away from the growing end of the bone. Conclusion: As vascularised osteocutaneous fibular graft is recommended as a useful treatment option for bone transplant surgeries, the data gathered in this study could be useful for the orthopaedic surgeons.

If arteries penetrate bones through foramina, regional artery blood flow rates can be estimated from the foramen sizes. Femoral bone blood flow rates estimated from nutrient foramen sizes were previously not absolute, but only a relative blood flow index (Qi), because the size relationship between the foramen and the occupying artery was unknown. The current study used vascular contrast and micro‐computerized tomographic scanning to investigate femoral nutrient foramen and nutrient artery sizes in three groups of sub‐adult chickens (non‐laying hens, laying hens, and roosters) of similar ages. The results indicate that the cross‐sectional area of the nutrient artery lumen occupies approximately 20.2 ± 4.1% of the foramen for femora with only one foramen. Artery lumen size is significantly correlated with foramen size. Vascular contrast imaging is capable of estimating blood flow rates through nutrient arteries, as blood flow rates estimated from artery lumen casts are similar to blood flow rates measured by infusion of fluorescent‐labeled microspheres. Laying hens tend to have higher nutrient artery perfusion rates than non‐laying hens, probably due to extra oxygen and calcium requirements for eggshell production, although the calculated blood flow difference was not statistically significant. Histological embedding and sectioning along with vascular contrast imaging reveal variable nutrient foramen morphology and nutrient artery location among femora with more than one nutrient foramen. [ABSTRACT FROM AUTHOR]

Variations in vascular anatomy are of great concern to surgeons, as proper identification of aberrant arteries can reduce the risk of iatrogenic injury and improve patient outcomes. Several studies have highlighted the irregular branching pattern of pelvic arteries, with a recent focus on the obturator artery (OA). The OA has an inconstant origin from the internal iliac artery, external iliac artery, or inferior epigastric artery. Within the pelvis, the OA can give off muscular branches and nutrient vessels to the ilium and pubis. Though occasionally described in text, few resources employ images of human donors that depict branches arising from the OAs. Out of the 34 hemisected pelves studied, we identified 1 individual with a substantial nutrient vessel branching unilaterally from the OA. Herein, we present the first image of this unconventional nutrient artery. This vessel should be highlighted given that its size and course make it particularly vulnerable during intrapelvic surgeries such as pelvic lymph node dissection or in procedures requiring arterial embolization of the OA. [ABSTRACT FROM AUTHOR]

Variations in vascular anatomy are of great concern to surgeons, as proper identification of aberrant arteries can reduce the risk of iatrogenic injury and improve patient outcomes. Several studies have highlighted the irregular branching pattern of pelvic arteries, with a recent focus on the obturator artery (OA). The OA has an inconstant origin from the internal iliac artery, external iliac artery, or inferior epigastric artery. Within the pelvis, the OA can give off muscular branches and nutrient vessels to the ilium and pubis. Though occasionally described in text, few resources employ images of human donors that depict branches arising from the OAs. Out of the 34 hemisected pelves studied, we identified 1 individual with a substantial nutrient vessel branching unilaterally from the OA. Herein, we present the first image of this unconventional nutrient artery. This vessel should be highlighted given that its size and course make it particularly vulnerable during intrapelvic surgeries such as pelvic lymph node dissection or in procedures requiring arterial embolization of the OA.

The location of nutrient foramina has been extensively studied in long bones; however, accurate information on the origin and extra-osseous course of the nutrient artery remains clearly defined in some long bones, although it is crucial to protect the nutrient arteries during operative procedures. In this study, we elucidated the origin and extra-osseous course of tibial and fibular nutrient arteries based on the 54 cadaveric legs. The tibial nutrient artery typically arose from the posterior tibial artery. Some of the tibial nutrient arteries arose from the anterior tibial, popliteal, and fibular arteries. The tibial nutrient artery arose from these parent arteries as a long descending branch. It penetrated the most proximal portion of the tibialis posterior or flexor digitorum longus to enter the tibial nutrient foramen. The fibular nutrient artery arose from the fibular artery as a short descending branch in all the cases. The fibular nutrient artery penetrated the flexor hallucis longus to enter the fibular nutrient foramen. Our present and previous findings provide new insight into the anatomical characteristics for the nutrient arteries in the long bones of upper and lower extremities. Namely, the nutrient arteries of the long bones go away from the elbow or knee to enter the nutrient foramina. [ABSTRACT FROM AUTHOR]

Introduction: Nutrient foramen is the largest opening on the shaft of the femur that conveys nutrient artery into the marrow cavity. Knowledge on locations of nutrient foramina is essential during surgical procedures as well as to rule out if the fracture line passes through the foramina. The purpose of the study was to determine the number and position of nutrient foramina in relation to length and topography of the femur. Methods: The study model was descriptive, cross-sectional study that included 151 femurs (71 right and 80 left side). The total number, location, and direction of nutrient foramina were investigated. Total length of femur and distance of foramen from the proximal end was measured with the 500mm 20" Digital Vernier Nib Jaw Caliper Metric/ Imperial Machine-DRO and finally Foraminal Index was calculated. Results: The analysis revealed 119(78.81%) of the femurs with single nutrient foramen, 31(20.52%) with double and 1(0.67%) with triple nutrient foramina. Foraminal Index II was found in 74(86.05%) on right side and 90(91.84%) on left side. The most common location of nutrient foramen was the medial lip of linea aspera (n= 77, 41.85%). All of the foramina were directed towards the proximal end. Conclusion: The present study has reported the majority of nutrient foramina located in the middle third of femur along the linea aspera. Thus, linea aspera should not be stripped off during surgical procedures to avoid damage to the nutrient arteries.

Abstract Background Osteotomies of the lesser (second to fourth) metatarsals are often used to correct forefoot deformities. However, certain areas of the lesser metatarsals where arteries may be prone to damage during surgery, and the resulting nonunion and delayed union could cause serious problems. This study sought to identify the nutrient arteries of the lesser metatarsals and to determine how osteotomy could injure these vessels. Methods Enhanced computed tomography scans of 21 ft (male, n = 10; female, n = 11; mean age 78.6 years at the time of death) were assessed. Twenty-one lower limbs in 21 cadaveric specimens were injected with barium via the external iliac artery, and the points at which the nutrient arteries entered the lesser metatarsals were identified on axial and coronal images. Results Each nutrient artery entered the lateral or medial plantar aspect of the lesser metatarsal in the middle third (just proximal to the middle point of the metatarsal) or proximal third obliquely from a distal direction. The mean ± standard deviation (SD) distances from the dorsal plane of the second, third, and fourth metatarsals to the point of entry of the nutrient artery in the axial plane were 8.2 ± 1.5, 7.6 ± 1.2, and 7.6 ± 1.5 mm, respectively. The mean ± SD distances from the distal epiphysis to the point of entry of the nutrient artery into the second, third, and fourth metatarsals in the coronal plane were 3.3 ± 1.1, 3.1 ± 1.0, and 2.8 ± 1.2 mm, respectively. The mean ± SD distances from the distal epiphysis to the point of entry of the nutrient artery into the second, third, and fourth metatarsals in the coronal plane were 46.0 ± 5.2, 40.9 ± 2.6, and 39.1 ± 3.7 mm, respectively. The mean ± SD distances from the proximal epiphysis to the entry point of the nutrient artery into the second, third, and fourth metatarsals in the coronal plane were 23.8 ± 4.7, 25.8 ± 4.3, and 25.0 ± 3.2 mm, respectively. Conclusions Distal metatarsal osteotomies might be safer than shaft or proximal osteotomy to avoid disruption of the nutrient artery, leading to delayed consolidation of the osteotomy and nonunion.

Nutrient arteries provide the endosteal blood supply to maintain bone remodelling and energy metabolism. Here, we investigated the distribution and function of perivascular nerves in regulating the contractility of the tibial nutrient artery. Changes in artery diameter were measured using a video tracking system, while the perivascular innervation was investigated using fluorescence immunohistochemistry. Nerve-evoked phasic constrictions of nutrient arteries were suppressed by phentolamine (1 μM), an α-adrenoceptor antagonist, guanethidine (10 μM), a blocker of sympathetic transmission, or fluoxetine (10 μM), a serotonin (5-hydroxytryptamine, 5-HT) reuptake inhibitor. In arteries pretreated with guanethidine, residual nerve-evoked constrictions were abolished by a high concentration of propranolol (10 μM) that is known to inhibit 5-HT receptors, or ketanserin (100 nM), a 5-HT2 receptor antagonist, but not SB207216 (1 μM), an antagonist of 5-HT3 and 5-HT4 receptors. Bath-applied 5-HT (100 nM) induced arterial constriction that was suppressed by propranolol (10 μM) or ketanserin (100 nM). Nerve-evoked arterial constrictions were enhanced by spantide (1 μM), a substance P (SP) receptor antagonist, or L-nitro arginine (L-NA; 100 μM), an inhibitor of nitric oxide synthase (NOS). Immunohistochemistry revealed 5-HT-positive nerves running along the arteries that are distinct from perivascular sympathetic or substance P-positive primary afferent nerves. For the first time, functional serotonergic nerves are identified in the tibial nutrient artery of the guinea pig. Thus, it appears that tibial nutrient arterial calibre is regulated by the balance between sympathetic and serotonergic vasoconstrictor nerves and vasodilator afferent nerves that release substance P-stimulating endothelial nitric oxide (NO) release. [ABSTRACT FROM AUTHOR]

The nutrient arteries, located in the long bone diaphysis, are the major blood supply to long bones, especially during the early phases of growth and ossification. Their intersection with the central axis of the medullary area corresponds to the ossification center, and their opening on the outer bone surface to the nutrient foramen. Nutrient arteries/foramen have essentially been analyzed in humans, and only to a much lesser extent in a few mammals. Some studies have taken measurements of the nutrient foramen; others have investigated the shape and orientation of the nutrient canals, although only partially. No studies have analyzed the nutrient canal in three dimensions inside the bone and the relationships between nutrient foramen, nutrient canal, growth, and physiology require further investigation. The current study proposes to investigate in three dimensions the shape of the nutrient canal in stylopod bones of various mammals. Qualitative and quantitative parameters are defined to discuss the diversity in, for example, morphology, orientation, and diameter encountered, resorting to two different datasets to maximize differences within mammals and then analyze variation within morphologically and phylogenetically closer taxa. This study highlights a strong intraspecific variation for various parameters, with limited biological signal, but also shows trends. It notably provides evidence that canals are generally more numerous and relatively thinner in less elongated bones. Moreover, it shows that the growth center is located distally in the humerus and proximally in the femur, and that the canals are essentially oriented towards the faster growing end, so that the nutrient foramen does not indicate the location of the growth center. This result seems general in mammals but cannot be generalized outside of Mammalia. Further analyses of the features of nutrient arteries in reptiles are required to make comparisons with the trends observed in mammals. [ABSTRACT FROM AUTHOR]

Introduction: The position of nutrient foramen on the shaft of long bones is specific. It transmits nerve and vessels which help in maintaining nutrition of bone. Blood supply by nutrient artery is essential during early phases of ossification as well as during growing period which passes through the nutrient foramen. Aim: To study the topography and location of nutrient foramen on the shaft of the tibia. Materials and Methods: For the present study, 70 adult dry tibia of unknown age and sex were studied. The number, direction and location of nutrient foramen were noted. Using Hughes formula, foraminal index was calculated. Results: A single nutrient foramen was present in all tibia. In all the bones they were directed downwards except in two bones where it was directed upwards. Nutrient foramen was situated on posterior surface except in two bones where it was on lateral surface of one bone and lateral border of other bone. Average total length of tibia was 35.11 cm while average distance of nutrient foramen from proximal end was 11.79 cm. In 45 tibia, foraminal index was

Nutrient artery is the principal source of nutrition to the long bones and a sound knowledge of its topography will help surgeons and oncologists in certain operative procedures to preserve the circulation. The aim of our study was to determine the direction and position of nutrient foramina with help of foramen index. The study was conducted in total 114 long bones of arm and forearm and the material collected for our study was from the department of Anatomy, ELMC&H, Lucknow and Department of Anatomy, King George's Medical University, Lucknow. Deformed and Damaged bones or bones with callus formation were excluded from the study. Direction of nutrient foramen was observed in all humerus (38 bones) downward. In case of radius (38 bones) and ulna (38 bones) the direction was found towards the upper end. In our study 92.10% humerus bones show the location of nutrient foramen in anteromedial surface. The anatomical data collected from this study elucidates the importance of nutrient arteries in microvascular bone transfer since it has become a very popular procedure. [ABSTRACT FROM AUTHOR]

Background: The aims of this study were to identify the artery feeding the fifth metatarsal and determine how bunionette osteotomy could injure this vessel.Methods: The nutrient artery entering the fifth metatarsal was investigated in 10 adult cadaveric lower limbs by barium injection and enhanced computed tomography.Results: The nutrient artery entered the medial aspect of the fifth metatarsal around the junction of the middle and proximal thirds obliquely from a distal direction (mean angle 36°) in the coronal plane in all cases; in the axial plane, the point of entry and direction of the artery was medial-plantar (mean angle 49°).Conclusions: This report revealed direction and location of the nutrient artery entering the fifth metatarsal. [ABSTRACT FROM AUTHOR]

Background: Osteotomy for hallux valgus interrupts intraosseous blood supply to the first metatarsal, presumably causing non-union, delayed union, or osteonecrosis of the head of the first metatarsal. We investigated the first metatarsal nutrient artery, arising from the first dorsal metatarsal artery, and identified aspects of surgical technique contributing to nutrient artery injury.Methods: Enhanced computed tomography scans of 8 feet of 8 fresh cadavers were assessed. Barium was injected through the external iliac artery; location and direction of the first metatarsal nutrient artery was recorded.Results: Mostly, the nutrient artery entered the first metatarsal at the distal third or junction of the middle and distal thirds obliquely from a proximal direction coronally; entry point and direction varied axially. Saw blade overpenetration alone or with extensive capsular stripping might damage the artery.Conclusions: Location and direction of the first metatarsal nutrient artery was established. [ABSTRACT FROM AUTHOR]

Background The localization of nutrient foramens has been extensively studied in humans and other vertebrate animals. However, accurate information on the origin and extraosseous course of the nutrient arteries in some types of long tubular bones is lacking. Terminologia Anatomica , the international standard on human anatomic terminology, lists the radial nutrient artery (RNA) and the ulnar nutrient artery (UNA) as branches of the radial and ulnar arteries, respectively. Anatomy textbooks published in both German- and English-speaking countries regard both the RNA and UNA as branches of the anterior interosseous artery. Methods To clarify the anatomic characteristics of the RNA and UNA in humans, we reexamined the origin and course of these arteries by cadaveric dissection. Results Almost all RNAs and UNAs branched from the ulnar artery or its tributaries. In typical cases, the RNA branched from the anterior interosseous artery and the UNA branched from the proximal part of the ulnar artery or the anterior interosseous artery. These findings are reasonable from the perspective of regional anatomy, since the ulnar artery passes more deeply than the radial artery in the proximal forearm and thus the proximal part of the ulnar artery and its major branches are situated more closely to the radial and ulnar nutrient foramens. Conclusions Based on our findings, it is necessary to correct the position of the RNA and UNA in the arterial hierarchy of T. Anatomica for accurate morphological description. [ABSTRACT FROM AUTHOR]

Background : Vascular insults to the radius either during fracture dislocation or during surgical correction of fracture may result in delayed healing or non-union of fracture. It is useful to find the number, location and size of nutrient foramina. The knowledge regarding nutrient foramina helps to protect them during conservative operative procedures of the bone, thus to concentrate upon the viability of the fractured segments. Objectives : To observe the location of nutrient foramina with reference to the different segments of shaft of radius, to note variations in number, direction and size of nutrient foramina. Further to examine if a correlation exists between the length of radius and number of nutrient foramina. Materials and methods : The study was undertaken on 100 dry normal adult radii. Observations were made using Hepburn’s osteometric board and hypodermic needles of different gauges. Statistical methods (SPSS) were used to analyze these observations. Results : The common site of location of diaphyseal nutrient foramina in radius was in upper third of shaft on anterior surface. Majority of nutrient foramina were of medium size and directed upward obliquely. Conclusions: The study will help in planning the surgical treatment of radius which will possibly reduce the post-operative complications.

Purpose: The objective of the following study is to determine the variation in diaphyseal nutrient foramen (NF) of humerus with respect to their number, location, direction and size. Materials and Methods: The present study was conducted on 100 humeri. The number and direction of diaphyseal NF were observed in all bones with the help of a hand lens. Position was described into horizontal and vertical zones; caliber was determined using hypodermic needles. Foraminal index was also calculated. Results: The mean length of humerus observed in the present study was 30.7 cm. The NF was situated at 17.8 cm from the proximal end, 12.4 cm from the distal end and ~2.9 cm below the mid length of humerus. The mean foramina index and circumference of NF was 57.7 and 6.2 cm respectively. Majority of the humeri (77%) had single NF while in 3% of humeri NF was absent. Middle one-third and on the antero-medial surface of the humerus was the most common location of the foramen. Majority of the dominant foramen was large in size and all were directing toward the distal end. Conclusion: The results of the present investigation indicate that there is variation in the number, location and size of NF in humeri among Indian population. An accurate knowledge of the location of the NF in long bones can be useful in certain surgical procedures such as bone grafting, microsurgical vascularized bone transplantation and in fractures.

Background: Vascular insults to the humerus either during fracture dislocation or during surgical correction of fracture may result in delayed healing or non-union of fracture. It is worth to find the number and size of nutrient foramina. The knowledge regarding the nutrient foramina helps to protect them during conservative operative procedures of the bone, thus to concentrate upon the viability of the fractured fragments. Objectives: To observe the location of nutrient foramina with reference to the different segments of shaft of humerus, to note variations in number, direction and size of the nutrient foramina. Further to examine if a correlation exists between the length of humerus and number of vascular foramina and nutrient foramina. Materials and methods: The study was undertaken on 200 dry normal adult humerus bones. Observations were made using Hepburn’s osteometric board and hypodermic needles of different gauges. Statistical methods (SPSS) were used to analyze these observations. Results: The location of nutrient foramen was more in the middle l/3rd of antero- medial surface. Majority of humeri showed one nutrient foramen, whereas there were 2 to 3 foramina in few humeri. Conclusion: This study will help in planning the surgical treatment of fracture of humerus which will possibly reduce the post-operative complications.

Objective: The nutrient foramina are reported as a cause for union defects in humerus, radius and ulna fractures. We aimed to review the relationship between the anatomy of the nutrient foramina and fractures of these bones. Materials and Methods: We performed an internet search via Pubmed and Google Scholar. We obtained full-text articles of 27 papers. We included 23 articles in our study. Eight studies investigated only humerus, 1 investigated radius, 1 investigated ulna, 1 investigated radius and ulna, and 12 investigated all three bones. We used additional 21 articles for a clinical viewpoint. Therefore 44 references were included in our study. Results: For humerus, foraminal index (the ratio of the distance between nutrient foramen and proximal end of the bone to total bone length) ranged between 32.7 and 59.1, and mostly the foramina located at the anteromedial surface. For radius, foraminal index ranged between 32.7 and 44.52, and mostly the foramina located at the anterior surface. For ulna, foraminal index ranged between 35.7 and 41.97, and mostly the foramina located at the anterior surface. Conclusion: The number and location of the foramina are concordant among different ethical groups. The most common site of union defects for humerus is the proximal 1/3. This complication is attributed to the attachments of strong skeletal muscles to this region. In forearm, non-unions tend to occur at the distal 1/3. At this region, blood supply is diminished due to the decrease of number of branches from the nutrient artery. [ABSTRACT FROM AUTHOR]

Introduction: Nutrient foramen is the external opening of the nutrient canal in a bone. An understanding of the location, number, direction and caliber of diaphyseal nutrient foramina in Tibia is very important clinically, especially in orthopedic surgical procedures. Method: This study was conducted on 312 (161 Right and 151 Left) macerated specimens of adult human Tibia. All the parameters like average number, average distance of the nutrient foramen from the upper end of Tibia, ‘foraminal index’, the most common location and the frequency of the location on the anatomical surfaces and borders of each of the Tibia, the caliber and the direction of each diaphyseal nutrient foramina and the frequency of the cases not obeying the Berard’s rule in Tibia is studied. Results: The average number of diaphyseal nutrient foramina found in Tibias was 0.97. Foraminal index (FI) was 45.01%; ranging from 32.86% to 28.09% and the mean FI was 37.57%. The location of nutrient foramina observed was 99.3% on the posterior surface. In 3 out of 312 tibiae there was nutrient foramina directed upwards and the tibiae had 100% dominant nutrient foramina. Conclusion: No author has reported tibia without NF and therefore the average number was always reported as greater than one, while we report 0.97. Also this is the first study where we report that in 3 tibias the Berard’s rule was not followed Therefore findings of this study do confirm the observations reported in earlier studies but some significant differences are also observed.