A descriptive study of morphology, topography and clinical significance of primary nutrient foramina in Tibia

Abstract

Introduction: Arterial supply to long bones comes through several vessels which enter the bone at different levels; they feed sinusoidal networks within the bone. Diaphysial nutrient arteries enter bone shaft obliquely through nutrient foramina. Foramens lead into nutrient canal. Nutrient arteries reach the medullary cavity through these canals where they divide into ascending and descending branches, which run toward epiphyses, dividing repeatedly into smaller helical branches close to the endosteal surface. Materials and Methods: This study was conducted in the department of Anatomy, Government Medical College, Kadapa from January 2020 to December 2020. We used 120 bones (60 of each side) available in our institute for teaching MBBS students. We do not have record of age and sex of the body donors from whose bodies the bones were obtained. We excluded old bones with indistinct/eroded features from our study. We did morphometric analysis of nutrient foramen with regard to its number and position. We noted surface orientation of the foramen on the tibia in each case, i.e., surface of the tibia on which it was present, relation to its borders, relation to soleal line, location (upper, middle, or lower third of shaft), and distance from the upper end. Measurements were done using digital. Results: Out of 120 tibias studied, 6 (2 of the right side Vernier caliper and 4 of the left side) presented with double foramen and rest of the bones had single foramen. Overall, we got 126 nutrient foramina and canal for observation. Only one canal (in a bone of the left side) was directed upward, and rest of the nutrient artery canals were directed downward. Conclusion: Knowledge about possible variations in number, position, and direction of nutrient canal can be of use for preservation of nutrient vessels during surgical procedures as well as in prognostic evaluation of the treatment given.