Humerus, Radius ve Ulna’daki Foramen Nutricium’ların Sayı ve Lokalizasyonlarının İncelenmesi

Öz

Amaç: kemiğe kan sağlayan a. nutricia’nın seyrettiği foramen nutricium (FN) önemli bir role sahiptir. Bu çalışmada, Türkiye kökenli kuru kemiklerden humerus, radius ve ulna’da FN sayısı, konumları ve transvers çapları araştırıldı. Gereç ve yöntem: Trakya Üniversitesi Tıp Fakültesi Anatomi Anabilim Dalı'nda bulunan 64 humerus, 37 radius ve 26 ulna kuru kemiği morfometrik olarak incelendi. FN yeri, sayısı ve transvers çapları ölçüldü. Foraminal indeks (FI) (kemiğin proksimal ucu ile FN arasındaki mesafenin kemiğin toplam uzunluğuna bölünmesiyle hesaplanır) her bir kemik için hesaplandı. Bulgular: Humerus kemiklerinin %81'inde FN sayısı tektir. Humerus kemiklerinin %80'inde FN anteromedial yüzeyde yer almaktadır. Humerus kemiklerinde FN'nin ortalama transvers çapı 1.2 mm ve ortalama FI 55.47'dir. Tüm radius kemiklerinde FN sayısı azdır ve anterior yüzeyde bulunurlar. Radius kemikleri için FN'nin ortalama transvers çapı 0,98 mm ve ortalama FI değeri 34,60'tır. Ulna kemiklerinin %92'sinde tek FN bulunur ve %89'unda kemiğin ön yüzündedir. Ulna kemiklerinde ortalama transvers FN çapı 1.24 mm ve ortalama FI değeri 37.16'dır. Sonuç: FN'nin konumu, sayısı ve morfometrik özelliklerinin bilinmesi, uzun kemik kırıklarının iyileşmesinde ve ekstremite üzerindeki tüm cerrahi veya ortopedik prosedürlerde kritik öneme sahiptir.

Anahtar Kelimeler

• humerus
• radius
• ulna
• foraminal indeks
• foramen nutricium

Examination of the number and localization of nutrient foramen in the humerus, radius, and ulna

Öz

Objective: Nutrient foramina (NF) have a crucial role in the nutrient artery supplying blood to the bone. This study investigates the number, location, and transverse diameter of nutrient foramina in humerus, radius, and ulna of dry bones of Turkish origin. Materials and Methods: 64 humerus, 37 radius, and 26 ulna dry bones were morphometrically examined at Trakya University, Faculty of Medicine, Department of Anatomy. The location, number, and transverse diameter of the nutrient foramina were measured. The foraminal index (FI) (calculated by dividing the distance between the proximal end of the bone and the nutricial foramen by the total length of the bone) was calculated for each of the bones. Results: The number of NF is single in 81% of the humerus bones. In 80% of the humerus bones, the NF is located on the anteromedial surface. The mean transverse diameter of the NF is 1.2 mm and the mean FI is 55.47 for humerus bones. In all radius bones, the number of NF is small and they are located on the anterior surface. The mean transverse diameter of NF is 0.98 mm and the mean value of FI is 34.60 for radial bones. The number of NF is simple in 92% of ulnar bones and in 89% it is on the anterior surface. The mean transverse diameter of NF is 1.24 mm and the mean value of FI is 37.16 in ulna bones. Conclusion: Knowledge of the position, number, and morphometric characteristics of the NF is of critical importance in healing long bone fractures and in all surgical or orthopedic procedures on limbs.

Anahtar Kelimeler

• humerus
• radius
• ulna
• foraminal index
• nutrient foramen

Kaynakça

1. Florencio-Silva R, Sasso GR, Sasso- Cerri E, Simões MJ, Cerri PS. Biology of Bone Tissue: Structure, Function, and Factors That Influence Bone Cells. Biomed Res Int. 2015;2015:421746. doi: 10.1155/2015/421746. Epub 2015 Jul 13. PMID: 26247020; PMCID: PMC4515490.
2. Korkmaz E, Gürses İA, Gayretli Ö, Öztürk A. Humerus, radius ve ulna’daki foramen nutrıcıum’ların anatomisi (bir derleme) İst Tıp Fak Derg 2016;79(1):32-7.
3. Mansur DI, Manadhar P, Haque MK, Mehta DK, Duwal S, Timalsina B. A Study on Variations of Nutrient Foramen of Humerus with its Clinical Implications. Kathmandu Univ Med J 2016;53(1):78-83.
4. Xue Z, Ding H, Hu C, Xu H, An Z. An anatomical study of the nutrient foramina of the human humeral diaphysis. Med Sci Monit 2016;22:1637-45.
5. Mysorekar VR. Diaphysial nutrient foramina in human long bones. J. Anat 1967; 101(Pt 4), 813.
6. Digby KH. The Measurement of Diaphysial Growth in Proximal and Distal Directions. J Anat Physiol 1916;50(2):187- 8.
7. Kizilkanat E, Boyan N, Ozsahin ET, Soames R, Oguz O. Location, number and clinical significance of nutrient foramina in human long bones. Ann Anat 2007;189:87- 95.
8. Chandrasekaran S, Shanthi KC. A study on the nutrient foramina of adult humerii. J Clin Diagn Res 2013;7(6):975-7.

9. Bharathi A, Janaki V, Gouri TLS, Archana. Morphometric variations of nutrient foramen in adult human humerus in Telengana region. IOSR-JDMS 2016;15(4):43-6.
10. Hughes H. The factors determining the direction of the canal for the nutrient artery in the long bones of mammals and birds. Acta Anat 1952;15:261-80.
11. Veeramuthu. M, Elangovan. M, Manoranjitham. Nutrient foramina: a study in the long bones of human upper extremities. Int J Anat Res 2017;5(3.3):4394-9.
12. Uzuner MB, Ocak M, Geneci F, Kocabıyık N, Sargon MF, Al-shouk A. Quantitative and Morphometric Evaluation of the Foramina Nutricia in the Long Bones of the Upper and Lower Extremities in Anatolian Population. Kafkas Tıp Bil Derg 2018;8(1):30-4.
13. Campos FF, Pellico LG, Alias MG, Fernandez-Valencia R. A study of the nutrient foramina in human long bones. Surg Radiol Anat 1987;9:251-5.
14. Şendemir E, Çimen A. Humerus diafizinde foramen nutricium sayısı ve yerleşimleri. Uludağ Üniversitesi Tıp Fakültesi Dergisi 1991;3:375-80.
15. Öztürk A, Arı Z, Bayraktar B, Şahinoğlu K, Olcay E. Humerus diafizinde foramen nutricium. Morfoloji Dergisi 1999;7:33-6.
16. Kumar, S., Sinha, S. K., Akhtar, M. J., Kumar, B., Sinha, R. R., & Kumar, A. (2022). Morphometric Study of the Nutrient Foramen of the Humerus in the Population of Bihar. Cureus, 14(12).
17. Haris, M., Haris, S., Deeba, F., & Khan, M. J. (2021). Anatomy of nutrient foramina of adult humerii in the Pakistani population: a cross-sectional study. Cureus, 13(10).
18. Murlimanju, B. V., Prashanth, K. U., Prabhu, L. V., Saralaya, V. V., Pai, M. M., & Rai, R. (2011). Morphological and topographical anatomy of nutrient foramina in human upper limb long bones and their surgical importance. Rom J Morphol Embryol, 52(3), 859-862.
19. Pereira GAM, Lopes PTC, Santos A, Silveira FHS. Nutrient Foramina in the Upper and Lower Limb Long Bones: Morphometric Study in Bones of Southern Brazilian Adults. Int J Morphol 2011;29(2):514–20.
20. Coolbaugh CC. Effects of Reduced Blood Supply of bone. American Journal of Physiology 1952;169:26.
21. Jupiter JB, von Deck M. Ununited humeral diaphyses. J Shoulder Elbow Surg 1998;7:644-53.