Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia

Kaan Çimen

EN TR

Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia

Abstract

Knowledge of the morphology and location of the tibial nutrient foramen is important for procedures involving the tibial shaft. This descriptive, cross-sectional osteological study evaluated 105 adult dry tibiae (52 right and 53 left) from the bone collection of the Department of Anatomy, Faculty of Medicine, Sivas Cumhuriyet University. The number, direction, surface location, longitudinal position, foramen index, and external diameter of the nutrient foramina were assessed. Five structurally damaged tibiae in which the nutrient foramen could not be measured reliably were excluded. All tibiae had a single nutrient foramen, and all nutrient canals were directed distally. Mean tibial length was 35.44 ± 2.46 cm, mean distance from the proximal end to the foramen was 10.75 ± 1.21 cm, and mean foramen index was 30.31 ± 2.52%. Median foramen diameter was 1.65 mm. The foramina were located predominantly on the posterolateral and posterior surfaces (47.6% each), and 86.7% were situated in the proximal third. No statistically significant side-related differences were observed. Tibial length correlated with the absolute proximal foramen distance but not with the foramen index or diameter. The tibial nutrient foramen therefore demonstrated a consistent proximal posterior or posterolateral distribution that should be considered during surgical exposure and fixation of the tibial shaft.

Keywords

Supporting Institution

This study received no financial support.

Ethical Statement

Ethical approval was obtained from the Sivas Cumhuriyet University Health Sciences Research Ethics Committee (decision no. 2026/08-46; date: August 6, 2026).

Tibia’da Foramen Nutricium’un Lokalizasyonu ve Morfometrik Özelliklerinin Değerlendirilmesi

Abstract

Tibia foramen nutriciumunun morfolojisi ve konumunun bilinmesi, tibia cismine yönelik cerrahi işlemler açısından önemlidir. Bu tanımlayıcı, kesitsel osteolojik çalışmada, Sivas Cumhuriyet Üniversitesi Tıp Fakültesi Anatomi Anabilim Dalı kemik koleksiyonundaki 105 erişkin kuru tibia (52 sağ, 53 sol) değerlendirildi. Bütünlüğü bozulduğu ve foramen nutriciumu güvenilir biçimde ölçülemediği için beş tibia dışlandı. Foramen nutriciumların sayısı, yönü, yüzey ve uzunlamasına konumu, foramen indeksi ve dış çapı incelendi. Tüm tibialarda tek bir foramen nutricium vardı ve besleyici kanalların tamamı distale yöneliyordu. Ortalama tibia uzunluğu 35,44 ± 2,46 cm, proksimal uç ile foramen nutricium arasındaki ortalama mesafe 10,75 ± 1,21 cm ve ortalama foramen indeksi %30,31 ± 2,52 idi. Ortanca foramen çapı 1,65 mm olarak bulundu. Foramenler çoğunlukla posterolateral ve posterior yüzeylerde (her biri %47,6) yer alıyordu; %86,7’si tibianın proksimal üçte birlik bölümündeydi. Sağ ve sol tibialar arasında istatistiksel olarak anlamlı fark saptanmadı. Tibia uzunluğu, foramen nutriciumun proksimal uçtan mutlak uzaklığıyla ilişkiliydi; foramen indeksi ve çapıyla ilişkili değildi. Foramen nutriciumun ağırlıklı olarak proksimal posterior veya posterolateral yerleşimi, tibia cismine yönelik cerrahi yaklaşımlarda ve tespit işlemlerinde dikkate alınmalıdır.

Keywords

Supporting Institution

Bu çalışma herhangi bir mali destek almamıştır.

Ethical Statement

Sivas Cumhuriyet Üniversitesi Sağlık Bilimleri Araştırmaları Etik Kurulu'ndan etik onay alınmıştır (karar no. 2026/08-46; tarih: 6 Ağustos 2026).

References

Almansour, H., Armoutsis, E., Reumann, M. K., Nikolaou, K., & Springer, F. (2020a). The anatomy of the tibial nutrient artery canal: An investigation of 106 patients using multi-detector computed tomography. Journal of Clinical Medicine, 9(4), 1135. https://doi.org/10.3390/jcm9041135
Almansour, H., Jacoby, J., Baumgartner, H., Reumann, M. K., Nikolaou, K., & Springer, F. (2020b). Injury of the tibial nutrient artery canal during external fixation for lower extremity fractures: A computed tomography study. Journal of Clinical Medicine, 9(7), 2235. https://doi.org/10.3390/jcm9072235
Erturk, M. (2003). Morphometry of the nutrient foramina in the shaft of the tibia. Medeniyet Medical Journal, 18(3), 150-153.
Forriol Campos, F., Gomez, L., Gianonatti, M., & Fernandez, R. (1987). A study of the nutrient foramina in human long bones. Surgical and Radiologic Anatomy, 9(3), 251-255. https://doi.org/10.1007/BF02109636
Gumusburun, E., Yucel, F., Ozkan, Y., & Akgun, Z. (1994). A study of the nutrient foramina of lower limb long bones. Surgical and Radiologic Anatomy, 16(4), 409-412. https://doi.org/10.1007/BF01627662
Kizilkanat, E., Boyan, N., Ozsahin, E. T., Soames, R., & Oguz, O. (2007). Location, number and clinical significance of nutrient foramina in human long bones. Annals of Anatomy, 189(1), 87-95. https://doi.org/10.1016/j.aanat.2006.07.004
Murlimanju, B. V., Prashanth, K. U., Prabhu, L. V., Chettiar, G. K., Pai, M. M., & Dhananjaya, K. V. N. (2011). Morphological and topographical anatomy of nutrient foramina in the lower limb long bones and its clinical importance. Australasian Medical Journal, 4(10), 530-537. https://doi.org/10.4066/AMJ.2011.725
Mysorekar, V. R. (1967). Diaphysial nutrient foramina in human long bones. Journal of Anatomy, 101(Pt 4), 813-822.

Details

Primary Language

English

Subjects

Clinical Sciences (Other)

Journal Section

Research Article

Authors

Kaan Çimen ^*
0000-0001-9781-7815
Türkiye

Publication Date

October 19, 2026

Submission Date

September 28, 2026

Acceptance Date

October 12, 2026

Published in Issue

Year 2026 Volume: 4

IZ

https://izlik.org/JA47CE78ZW

Cite

RIS / Bibtex

APA

Çimen, K. (2026). Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia. Health Services Research Journal, 4, 106-111. https://izlik.org/JA47CE78ZW

AMA

1.Çimen K. Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia. HES Journal. 2026;4:106-111. https://izlik.org/JA47CE78ZW

Chicago

Çimen, Kaan. 2026. “Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia”. Health Services Research Journal 4 (October): 106-11. https://izlik.org/JA47CE78ZW.

EndNote

Çimen K (October 1, 2026) Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia. Health Services Research Journal 4 106–111.

IEEE

[1]K. Çimen, “Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia”, HES Journal, vol. 4, pp. 106–111, Oct. 2026, [Online]. Available: https://izlik.org/JA47CE78ZW

ISNAD

Çimen, Kaan. “Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia”. Health Services Research Journal 4 (October 1, 2026): 106-111. https://izlik.org/JA47CE78ZW.

JAMA

1.Çimen K. Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia. HES Journal. 2026;4:106–111.

MLA

Çimen, Kaan. “Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia”. Health Services Research Journal, vol. 4, Oct. 2026, pp. 106-11, https://izlik.org/JA47CE78ZW.

Vancouver

1.Kaan Çimen. Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia. HES Journal [Internet]. 2026 Oct. 1;4:106-11. Available from: https://izlik.org/JA47CE78ZW

Manuscripts must be written in either Turkish or English. In order to ensure the smooth progress of the manuscript evaluation process, the following documents must be uploaded to the system completely and in accordance with the provided templates. The uploaded files will be reviewed, and in case of non-compliance with the template or missing documents, the author will be asked to make the necessary revisions.

Under the “Forms and Templates” page, the following documents can also be accessed:

The abstract should be written without a heading, must not exceed 250 words, and should include at least 3 and at most 5 keywords. Keywords must be separated by commas, and the first letter of each keyword must be capitalized.
A single space should be left after punctuation marks in the text.
In Turkish texts, commas should be used as decimal separators.
Lines should not begin with numbers, abbreviations, or symbols.
Frequently used terms consisting of multiple words should be abbreviated using their initials. Abbreviations should be defined at their first occurrence, followed by the abbreviation in parentheses. Standard abbreviations such as TÜBİTAK or cm may be used without definition. Example: World Health Organization (WHO).
Similarity rates must not exceed 20% in total according to plagiarism detection software, and no single reference should exceed 1%.
APA (7th Edition) citation style must be used for both in-text citations and references. Accordingly, sources should be cited in parentheses with the author’s surname and year. Example: (Kaya, 2021; Aytaç and Yakın, 2024; Bulut et al., 2025).
References in the text must be consistent with the reference list. Reference management software (EndNote, Mendeley, etc.) may be used. DOI numbers must be included. If the manuscript is written in Turkish, “ve” should be used; if in English, “and” should be used.

Citation Format

Single Author
In-text (parenthetical):
→ (Kaya, 2021)

In-text (narrative):
→ Kaya (2021) stated that...

Reference list:
Kaya, M. (2019). Burnout levels and affecting factors among healthcare workers. Health and Society Journal, 29(3), 145–152. https://doi.org/10.5455/stdergi.2019.14552

Two Authors
In-text (parenthetical):
→ (Yıldız and Demirtaş, 2020)

In-text (narrative):
→ Yıldız and Demirtaş (2020) stated that...

Reference list:
Yıldız, Z., Demirtaş, E. (2020). Problems encountered in the use of hospital information systems. Health Informatics Research Journal, 5(2), 75–83. https://doi.org/10.31023/sbad.2020.75

Three or More Authors
In-text (parenthetical):
→ (Evcili et al., 2012)

(Note: “vd.” is used in Turkish literature — “et al.” is used in English.)

In-text (narrative):
→ Evcili et al. (2012) stated that...

Reference list:
Evcili, H., Kara, F., Tunç, M. (2012). The use of electronic health records by nurses. Clinical and Experimental Research Journal, 4(1), 22–29. https://doi.org/10.17826/kdad.2012.22

Edited Books
Özbek, M. (Ed.) (2005). Public Sphere. Istanbul: Hil

Book Chapter in Edited Book
Kejanlıoğlu, B. (2005). The concept of public sphere in media studies. In Meral Özbek (Ed.), Public Sphere (pp. 689–713). Istanbul: Hil.

Books with Multiple Editions
Strunk, W. Jr., White, E. B. (2000). The Elements of Style (4th ed.). New York: Longman.

Electronic books and journals
Chan, H. F., Guillot, M., Page, L., Torgler, B. (2015). The inner quality of an article: Will time tell? Scientometrics, 104:19–41. DOI:10.1007/s11192-015-1581y

Turner, S. J. (2010). Website statistics 2.0: Using Google Analytics to measure library website effectiveness. Technical Services Quarterly, 27:261–278. DOI: 10.1080/07317131003765910

Al, U., Soydal, İ. (2014). Library Turkey Project: Public library usage research. Turkish Librarianship, 28:288–307. Access link: http://www.tk.org.tr/index.php/TK

Web page
Hacettepe University. (n.d.). Mission, vision and values. Access link: http://hacettepe.edu.tr/hakkinda/misyonvizyondegerler (Access date: January 4, 2023)

Ethical Principles and Publication Policy

The publication processes implemented by the Health Services Research Journal (HES Journal) serve as the foundation for the impartial and respected development and dissemination of knowledge. In this regard, the processes applied directly reflect the quality of the works of authors and the institutions supporting them. Peer-reviewed studies are those that concretely embody and support the scientific method. At this point, it is essential that all stakeholders of the process (authors, readers and researchers, publisher, reviewers, and editors) comply with ethical standards. Within the scope of publication ethics, our journal expects all stakeholders to adhere to the following ethical responsibilities.

The ethical duties and responsibilities outlined below have been prepared in accordance with the guidelines and policies published by the Committee on Publication Ethics (COPE) under open access principles.

A- Ethical Duties and Responsibilities of Authors

Submitted manuscripts are expected to be original. If authors use or benefit from other works, they must provide complete and accurate citations and/or quotations. Paraphrasing methods, etc., are considered ethical violations by our journal.
Individuals who do not intellectually contribute to the content of the study should not be listed as authors.
In copyrighted works, the author who contributes the most should be listed as the first author; academic title superiority alone does not justify first authorship.
Any potential conflicts of interest must be disclosed in submitted manuscripts.
Authors may be requested to provide raw data during the evaluation process and must be prepared to submit such data to the editorial and scientific boards when required.
Authors must possess documentation proving they have the rights to use the data, necessary permissions for research/analysis, or informed consent from participants. Even if not requested by the journal, such documentation must be available.
If authors identify an error or mistake in a published, early-view, or under-review manuscript, they are obliged to inform the editor and cooperate in correction or retraction processes.
Authors may not submit the same manuscript to more than one journal simultaneously. Each submission must follow the completion of the previous process. Previously published works cannot be submitted to our journal.
Changes in authorship (addition, removal, or order change) are not permitted after the evaluation process has begun. However, in the DergiPark system, such requests may be considered by HES Journal if submitted by the corresponding or first author with signed consent forms from all co-authors.

B- Ethical Duties and Responsibilities of Editors

HES Journal editors and section editors are required to adhere to the following ethical duties and responsibilities based on the open-access guidelines published by the Committee on Publication Ethics (COPE), namely the COPE Code of Conduct and Best Practice Guidelines for Journal Editors and COPE Best Practice Guidelines for Journal Editors:

Editors are responsible for all publications in the journal. In this context, they undertake the following roles and obligations:
Strive to meet the information needs of readers and authors.
Continuously work toward the development and improvement of the journal.
Take an active role in improving the quality of published works.
Support freedom of thought and encourage the inclusion of original and foreign-language works.
Ensure processes comply with intellectual property rights and ethical standards.
Ensure transparency in cases requiring correction or clarification.
Support field editors through guidance and communication via digital and verbal means.
Consider feedback from readers, researchers, and practitioners and provide informative responses.
Manuscripts within scope should be included in preliminary evaluation unless there is a serious issue.
Positive reviewer recommendations should not be ignored unless justified by serious concerns.
Decisions made by previous editors should not be changed without serious justification.
Assist section editors in maintaining the blind review process and prevent breaches of anonymity.
Ensure efficient management of peer-review and editorial workflows.
Encourage the development of the reviewer pool.
Protect intellectual property rights of all published works and defend the rights of authors and the journal against violations.
Take constructive criticism of published works into account.
Ensure authors are given the right to respond to criticism.
Handle complaints from authors, reviewers, and readers carefully and respond clearly and informatively.
Editorial independence must not be influenced by the publisher or any political or commercial entity.
Ensure rapid correction of errors, inconsistencies, or misleading statements in published works.

C- Ethical Duties and Responsibilities of Section Editors

Assign reviewers appropriate to the manuscript’s subject area.
Provide necessary guidance and information for reviewers.
Monitor potential conflicts of interest between authors and reviewers.
Ensure confidentiality in the blind review process.
Encourage objective, scientific, and impartial evaluations.
Evaluate reviewer performance based on timeliness and quality.
Implement policies to improve reviewer performance.
Maintain and regularly update the reviewer database.
If both reviewers reject a manuscript, the section editor may, if deemed scientifically valuable, send it to a third or fourth reviewer.
Maintain communication with authors throughout the process.
Rejection decisions should be communicated respectfully and with clear justification.

D- Ethical Duties and Responsibilities of Reviewers

Review at HES Journal is conducted under a double-blind peer review system. Reviewers must not communicate directly with authors.
Accept reviews only within their area of expertise.
Maintain confidentiality and impartiality.
Decline review if a conflict of interest exists.
Destroy manuscripts after review; only published final versions may be used.
Base evaluations solely on academic content, without discrimination.
Provide constructive and respectful feedback.
Complete reviews in a timely manner.
Protect intellectual property rights and journal copyrights.
Take precautions against academic misconduct, citation manipulation, and plagiarism.

E- Ethical Duties and Responsibilities of the Editorial Board

The Editorial Board of HES Journal is responsible for ensuring that all published articles comply with journal policies and international standards.

The editorial board consists of the Editor-in-Chief, Section Editors, Language Editors, Layout Editors, and Technical Editors.
Address deficiencies in content, technical, and visual aspects of the journal.
Actively participate in editorial meetings.
Hold regular meetings to improve journal policies and development.
Editorial independence must be maintained without interference from publishers.
Editors are responsible for all processes of submitted manuscripts.

F- Protection of Personal Data

HES Journal ensures the protection of personal data of research participants unless written consent is provided.
Protects personal data of editors, reviewers, authors, and readers.
Ensures protection of human and animal rights; manuscripts without ethics committee approval may be rejected.

G- Measures Against Misconduct

HES Journal takes necessary measures against misconduct and abuse of duty. Allegations are carefully investigated, and findings are evaluated objectively and reported by the editorial board.

H- Research and Publication Ethics

Research ethics ensures that studies are designed and conducted in accordance with ethical principles such as autonomy, non-maleficence, beneficence, and justice. The journal ensures that ethical issues, including conflicts of interest, are evaluated within international legal and ethical frameworks and ultimately decided by the ICAM Network Ethics Committee.

I- Handling Ethical Violations

Any unethical behavior or content beyond the responsibilities stated above should be reported to the HES Journal email address. Reports are evaluated by the editorial board and concluded with a final decision.

Baş Editör

Funda EVCILI

Health Sciences

Alan Editörleri

ŞE

Şükran ERTEKIN PINAR

Mental Health Nursing

Gülay DEMIR

Decision Support and Group Support Systems, Data Analysis, Biostatistics, Large and Complex Data Theory, Statistical Analysis, Spatial Statistics, Quantitative Decision Methods , Theory of Sampling, Multiple Criteria Decision Making

HG

Handan GÜLER

Health Sciences, Midwifery, Nursing, Obstetrics and Gynocology Nursing

Gülşen GÜÇLÜ

Biological Sciences, Plant Biochemistry, Biochemistry and Cell Biology, Genetics

Ferdağ YILDIRIM

Pediatric Health and Illnesses Nursing

Mine BEKAR

Obstetrics and Gynocology Nursing

Fatma HASTAOĞLU

Geriatrics and Gerontology, Health Sciences, Nursing, Internal Diseases Nursing, Aged Health Care

Berna BAYSAL BAKAY

Medical Parasitology

Sebahattin KARABULUT

Medical Physiology (Other)

Songül ULUSOY

Analytical Chemistry, Analytical Spectrometry, Bioassays, Instrumental Methods, Separation Science

SH

Sevda HASTAOĞLU ÖRGEN

Terrestrial Ecology, Evolutionary Ecology, Animal Systematics and Taxonomy, Entomology

Erdoğan ÖZDEMIR

Physics Education

PÇ

Pelin ÇELIK

Nursing, Internal Diseases Nursing

Ayşegül ÖZTÜRK

Physiopathology, Cell Physiology

AÇ

Arzuhan ÇETINDAĞ

Physiopathology, Health Sciences, Nursing

Fatma TOK YILDIZ

Nursing, Fundamentals of Nursing

Kübra ASLAN

Health Policy, Health Literacy, Physiotherapy, Rehabilitation, Digital Health, People With Disability, Patient Safety, Health Management, Aged Health Care, Health Services and Systems (Other)

BÇ

Betül Esra ÇEVIK

Health Sciences Education and Development of Programs: Medicine, Nursing and Health Sciences, Public Health Nursing

Yazım ve Dil Editörleri

TH

Tuğba HERGÜNER

Prosthodontics, Dental Public Health

Ezgi YILDIZ

Fundamentals of Nursing

BÇ

Betül Esra ÇEVIK

Health Sciences Education and Development of Programs: Medicine, Nursing and Health Sciences, Public Health Nursing

Mizanpaj Editörleri

BS

Buse SEMERCI ARIKAN

Medical Biochemistry - Amino Acids and Metabolites, Medical Biochemistry - Carbohydrates, Medical Biochemistry - Proteins, Peptides and Proteomics

Kübra ASLAN

Health Policy, Health Literacy, Physiotherapy, Rehabilitation, Digital Health, People With Disability, Patient Safety, Health Management, Aged Health Care, Health Services and Systems (Other)

Teknik Editörler

Burak ATIK

Physical Medicine and Rehabilitation, Rehabilitation

Mehmed KOÇ

Artificial Intelligence (Other), Nanotechnology

Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia

Morphometric and Topographic Evaluation of the Nutrient Foramen of the Tibia

Abstract

Keywords

Supporting Institution

Ethical Statement

Tibia’da Foramen Nutricium’un Lokalizasyonu ve Morfometrik Özelliklerinin Değerlendirilmesi

Abstract

Keywords

Supporting Institution

Ethical Statement

References

Details

Primary Language

Subjects

Journal Section

Authors

Publication Date

Submission Date

Acceptance Date

Published in Issue

IZ

Cite

Aim & Scope

Author Guidelines

Citation Format

Ethical Principles and Publication Policy

Indexes

Other Indexes

Journal Boards

Baş Editör

Alan Editörleri

Yazım ve Dil Editörleri

Mizanpaj Editörleri

Teknik Editörler

	Türk Medline Ulusal Sağlık Bilimleri Süreli Yayınlar Veritabanı
	ResearchBib