Diaphysial nutrient foramina in human phalanges

Abstract

Phalanges, like the metacarpals and metatarsals, are classified as 'short long bones'. The main blood supply, particularly during the period of active growth, is from a nutrient artery which enters the bone obliquely through the nutrient canal which is directed away, as a rule, from the growing end. In a study of human long bones, metacarpals and metatarsals, anomalously directed canals were only found in the fibula (Mysorekar, 1967;Patake & Mysorekar, 1977). Hardly any information is available about the nutrient foramina in phalanges. Trotter & Peterson (1966) simply mention that in all the phalanges of the hand and foot the nutrient canal is directed towards the distal extremity. Wood Jones (1946) stated that the nutrient foramen of each phalanx is situated on the palmar aspect of the shaft not far from the distal end: it may be single, in which case it is mesially placed, or there may be two, one close to each border. In all cases the canal is directed towards the distal end and the nutrient arteries are branches of the corresponding palmar digital arteries. He further said that the nutrient foramen in each phalanx of the foot is directed towards the distal end, but the source of the nutrient arteries was not given. The present observations on the phalanges were undertaken to complete our study of the nutrient foramina in long and 'short long' bones. MATERIAL AND METHODS1770 phalanges of the hand and 660 phalanges of the foot, of unknown sex, from the collections in the anatomy departments of five medical colleges, were studied. Only diaphysial nutrient foramina in normal bones were examined, pathological specimens being rejected. A nutrient foramen had a well marked groove leading to it and a clear cut, often slightly raised, margin. It was sometimes difficult to identify a foramen with certainty with the naked eye; hence, in all cases, use was made of a watchmaker's magnifier.The length of the bone (L) was measured by means of a sliding caliper. The distance of the foramen from the base (D) was measured by means of a divider and read on a scale graduated in millimetres. The foraminal index (F.I.) = D/L x 100 (Hughes, 1952).The positions of foramina in relation to the surfaces of the bones, or to the borders between the surfaces in the case of the phalanges of the hand, were noted. When the foramina were within 1 mm of the actual border they were regarded as being on the border.The direction of canals was noted, and in cases of doubt a fine stiff wire was passed through a foramen to confirm its direction.The proximal phalanges of the thumb and great toe were considered separately as these were readily distinguishable in skeletal collections.

A Study of the Nutrient Foramina in the Shaft of the Fibula

“…This has been found similarly in other studies (Fen, 1981;Forriol, 1987;Giim4burun, 1994;McKee, 1984;Mysorekar, 1967;Restrepo, 1980; $endemir, 1991) ( Table 3). The fibula with none and with two foramina were both 3.9% in our study, and ranged from 0 to 18.8 and from 0 to 11.7 in others respectively (Fen, 1981; Mailing Address: Associate Prof. Dr. Erdem Giim4burun, Department of Anatomy, Faculty of Medicine, Cumhuriyet University, 58140 Sivas-Tiirkiye 125 E. Grtimii §burun et al (Table 3).…”

“…Most of the foramina were reported to be in the middle third of the bone by some authors (Forriol, 1987;Gfimi4burun, 1994;McKee, 1984;Mysorekar, 1967;Restrepo, 1980), in the middle two fourths by Taylor (1975) (1979), in the third sixth by Sendemir (1991) and in the upper third by Fen (1981). We determined that the 98.0% of the foramen were in the middle third.…”

“…This was not observed in this study. Mysorekar (1967) noted the foramen frequently Table 3. Percentage distribution of the number of nutrient foramina in this and other studies on the medial crest, McKee (1984) and Giimii §burun (1994) on the posterior surface, Forriol (1987) equally on the medial and posterior surfaces and endemir (1991) on the medial surface.…”

“…Therefore, the fibula is an ideal graft for reconstructing a long bone, especially when the skeletal defect is large. Finally, knowledge of the localization of the nutrient foramina can be useful during the transplantation of the free vascularized bone grafts in microsurgery to preserve the circulation (Fen, 1981;McKee, 1984;Mysorekar, 1967;Taylor, 1979). To exclude the possible vascular anomalies in both recipient and donor limbs, the importance of preoperative angiografy still remains.…”

A study of nutrient foramina of the dry adult human femur bones

“…There are often two nutrient foramina in the Femur. In the Femur, the nutrient foramina are restricted to the linea aspera or its immediate neighbourhood in the middle third of the bone [6].…”