Abstract
Introduction: Human beings are bestowed with the power of bipedal locomotion and the clavicle acts as a strut to allow the free movement of the upper limb away from the chest wall.2
The clavicle (collar bone) is an unusual long bone which has many unique embryologic features.14
Aims & Objectives: The main aim of this study is to find variation in number and position of nutrient foramen of the human clavicle which enlightens the operating surgeon in the free vascularised bone grafts and in microsurgical vascularised bone transplantation.
From recent hypothesis it has been confirmed that vascularized bone and joint allograft survival depends strongly on the blood supply of bone.17
Material & Methods: Our study comprised of 50 (25 Right sided & 25 left sided) dry human clavicles collected irrespective of age and sex, obtained from department of Anatomy at S.M.S. Medical College & Hospital Jaipur.
Results & Conclusions: In our Present study Nutrient foramina was present in 47(97%) clavicles. Out of which single foramina in 34(68%) and double foramina in 13(26%). Absence of nutrient foramina were found in 3(6%) clavicles.
Maximum number was present in the middle third and on the posterior surface of 38(76%) bones.
Majority of the formina were directed towards the acromial end which showed that sterna end of the clavicle was the growing End and followed the laws of ossification. Only two foramina were directed towards sterna end.
The knowledge of the nutrient foramina is essential in some surgical procedures like placement of internal fixation, in vascularised bone graft and also to preserve arterial supply during radiation therapy.
Keywords: Nutrient foramina, clavicle, bone grafting.
References
- Al-Motabagoni. The arterial architecture of the human femoral J. Anat. Soc. India 2002;51(1): 27 - 31.
- Arch, Gener, De Med II Serie 1835; 2(7): 176-183.
- D. chaurasia – Human Anatomy, 7thEdition,Vol -1 ;2015; page 6-9.
- Bokariya , Gudadhe, Kothari, Murke, MRShende (2012) Comparison of Humerus and Femur with Respect to Location and Number of Nutrient Foramina. Indian Journal of Forensic Medicine and Pathology 2: 79-81.
- Chatrapathi Mishra BD. Position of nutrient foramen on the shaft of the human long bones. Journal of Anatomical Society of india.june 1965; 14: 54-63.
- Coolbaugh, C. (1952) Effects of Reduced Blood Supply of bone. American Journal of Physiology 169:26.
- Craig, G., Widman, D., van Holsbeeck, M. Longitudinal stress fracture: patterns of edema and the importance of the nutrient foramen. Skeletal Radiol. 2003;32:22 - 27..
- Fischer LP, Carret JP (1978) Vascularisation artérielle des os chez l’homme. Bull Assoc Anat 62: 419–454.
- Fraizer, Ernest The Anatomy of Human Skeleton 4th Edition (1964).p5
- Freyschmidt J, Sternberg A, Brossmann J, Wiens J (2003) Borderlands of normal and early pathological findings in skeletal radiography, 5th Thieme, New York, p 305-318.
- Gotzen, , Cross, A., IFju, P., Rapoff, A. Understanding stress concentration about a nutrient foramen.J.Biomech. 2003, 36:1511-1521.
- Gray's The Anatomical Basis of Clinical Practice 40th ed. 2008, Standring S, Healy JC, Johnson D, Collins P, etal editors, London: Elsevier Churchill Livingstone;.p.792
- Gumusburun, , Yucel, F., Ozkan, Y., Akgun, Z. (1994) A study of the nutrient foramina of lower limb long bones. Surg. Radiol. Anat 16:409 – 412
- Havet E, Duparc F, Tobenas-Dujardin A-C, Muller J-M, Delas B, Freger P (2008) Vascular anatomical basis of clavicular non-union. Surg Radiol Anat 30: 23-28.
- Humphrey Observations on the growth of the long bones and of the stumps. Medico Chir. Trans.1861; 44: 117- 134.
- Johnson, W. (1927) A Physiological study of the Blood Supply of the Diaphysis, Journal of Bone & Joint Surgery 9:15.
- Kennedy, C., Wyatt, J. K. (1957) An Evaluation of the Management of Fractures through the Middle Third of the Humerus. Canadian Journal of Surgery1:26.
- Knudsen FW, Andersen M, Krag C (1989) The arterial supply of the Surg Radiol Anat 11: 211-214.
- Kumar R, Lindell MM, Madewell JE, David R, Swischuk LE (1989) The clavicle: Normal and Radiographics 9: 677-706.
- Lewis, J. (1956). The blood supply of developing long bones with special reference to the metaphysic.J.Bones Jt surg. 38:928-933.
- Longia, S., Ajmani, M.L., Saxena, S.K., Thomas, R.J. (1980) Study of diaphyseal nutrient foramina in human long bones. Acta Anat.Basel 107: 399 - 406.
- Mercer,Sir (1959) Orthopaedic Surgery, 5th edition. London: Edward Arnold Ltd.
- Murlimanju BV, Prabhu LV, Pai MM, Yadav A, Dhananjaya KV, Prashanth Neurovascular foramina of the human clavicle and their clinical significance. Surg Radiol Anat. 2011; Oct;33(8):679
- Ojaswini Malukar, Hemang Joshi, Diaphysial Nutrient Foramina in long Bones sand Miniature Long NJIRM 2011; vol2 (2) pg 23-26
- Rahul Rai, Shailaza Shrestha, B Kavitha (2014) Morphological and topographical anatomy of nutrient foramen in clavicles and their clinical importance. IOSR Journal of dental and medical sciences 13(1):37-40
Corresponding Author
Puneet Joshi
Ph.D. Scholar, Department of Anatomy,
S.M.S. Medical College, Jaipur, Rajasthan, India