Türk Populasyonunda Üst Ve Alt Ekstremite Uzun Kemiklerinde Foramen Nutricium’larin İncelenmesi

Öz

Amaç: Üst ve alt ekstremite uzun kemiklerinde foramen nutricium’ların varlığını, sayısını, anatomik konumunu incelemeyi ve foramen indeksini hesaplamayı amaçladık.
Materyal ve Metot: Çalışmamız 25 clavicula, 59 humerus, 49 radius, 32 ulna, 59 femur, 49 tibia ve 22 fibula olmak üzere toplam 295 kemik üzerinde gerçekleştirildi. Bütün kemiklerdeki foramen nutricium’ların sayısı, foramen nutricium’ların kemik üzerindeki anatomik konumu ve açıklığının yönü belirlenerek kaydedildi. Tüm kemikler bir milimetrik cetvel ile fotoğraflandı. Kemik uzunluğu ve foramen nutricium’ların kemiğin proksimaline olan mesafesi ImageJ programı kullanılarak ölçüldü. Bütün foramenler için foramen indeksi hesaplandı.
Bulgular: Bir humerus ve üç fibula dışında tüm kemiklerde en az bir foramen nutricium gözlendi. En yüksek foramen indeksi ortalaması humerus ve clavicula’ya aitken, en düşük foramen indeksi ortalaması tibiaya aitti. Foramen nutricium’ların açıklığının yönü clavicula’da çoğunlukla extremitas acromialis’e (%87,5), humerus’ta (%97,6), tibia (%96,15) ve fibula’da (%75) distale ve radius (%96,36), ulna (%100) ve femur’da (%98,97) proksimale doğruydu.
Sonuç: Üst ve alt ekstremite kemiklerinin birlikte incelendiği ve popülasyonlar arası karşılaştırmaların yapıldığı foramen nutricium’larla ilgili az sayıda çalışma bulunmaktadır. Bu nedenle çalışmamızın bu konudaki sınırlı literatürü zenginleştireceğini ve klinisyenlere katkı sağlayacağını düşünüyoruz.

Anahtar Kelimeler

• Foramen indeksi; kırık; lokalizasyon; arteria nutricia

An Investigation of the Nutrient Foramen in the Long Bones of the Upper and Lower Limbs in Turkish Population

Abstract

Aim: We aimed to examine the presence, number, anatomic location of the nutrient foramen in the long bones of the upper and lower limbs and calculate the foramen index.
Materials and Methods: Our study was conducted on a total of 295 bones, including 25 clavicle, 59 humerus, 49 radius, 32 ulna, 59 femur, 49 tibia, and 22 fibula. The number of the nutrient foramen in each bone, the anatomic location of the nutrient foramen on the bone, and the direction of its opening were determined and recorded. All bones were photographed with a millimeter ruler. The bone length and the distance of the nutrient foramen to the proximal of the bone were measured using the ImageJ program. The foramen index was calculated for each foramen.
Results: At least one nutrient foramen was observed in all bones, except for one humerus and three fibula. The highest mean foramen index belonged to the humerus and clavicle, while the lowest mean foramen index belonged to the tibia. The direction of the nutrient foramen is mostly toward the acromial end (87.5%) in the clavicle, toward the distal in the humerus (97.6%), tibia (96.15%) and fibula (75%), and toward the proximal in the radius (96.36%), ulna (100%), and femur (98.97%).
Conclusion: There are few studies on the nutrient foramen in which bones of the upper and lower limbs are examined together and comparisons between populations are made. Therefore, we think that our study will enrich the limited literature on this subject and contribute to clinicians. 

Keywords

• Foramen index
• fracture
• localization
• nutrient artery

Kaynakça

1. Azizi J, Danish H. Anatomical study of nutrient foramen in the long bones of upper extremities. Int J Eng Appl Sci Technol. 2019;4:7-10.
2. Zahra SU, Kervancioglu P, Bahsi I. Morphological and topographical anatomy of nutrient foramen in the lower limb long bones. Eur J Ther. 2018;24:36-43.
3. Yaseen S, Nitya W, Ravinder M. Morphological and topographical study of nutrient foramina in adult humerii. Int J Innov Res Sci Eng Technol. 2014;3:7-10.
4. Korkmaz E, Gurses IA, Gayretli O, Ozturk A. Anatomy of the nutrient foramen on the humerus, radius and ulna: A review. J Istanbul Fac Med Tip Fak Derg. 2016;79:32-7.
5. Kizilkanat E, Boyan N, Ozsahin ET, et al. Location, number and clinical significance of nutrient foramina in human long bones. Ann Anat. 2007;189:87-95.
6. 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.
7. Rathwa AJ, Chavda SR. A study on variations of nutrient foramen of humerus with its clinical implications. Int J Anat Res. 2019;7:6132-7.
8. Chavda HS, Jethva NK. Morphometric study of nutrient foramen of adult human tibia bone. International Journal of Anatomy, Radiology and Surgery. 2019;8:5-8.

9. Kumar D, Raichandani L, Kataria SK, Singh J. Variation in number and position of nutrient foramen of clavicle – A morphological study in Western Rajasthan. IP Indian J Anat Surg Head, Neck Brain. 2019;5:67-71.
10. Saha PK, Mondal M, Sarkar S, Bhaumik D. An osteological study of the nutrient foramina of human clavicle. J Anat Soc India. 2017;6:429-35.
11. Rai R, Shrestha S, Kavitha B. Morphological and topographical anatomy of nutrient foramina in human clavicles and their clinical importance. IOSR J Dent Med Sci. 2014;13:37-40.
12. Tanna N, Tanna V. Anatomical variation in position, direction, and number of nutrient foramina in clavicles. Int J Med Sci Public Heal. 2015;4:357-9.
13. Hussain A, Khalid J, Rauf A. Nutrient Foramen; Study of nutrient foramen in dried human clavicle. Prof Med J. 2018;25:1252-55.
14. Gupta AK, Ambekar MN. Study of nutrient foramina in adult human femur bones. J Nepalgunj Med Coll. 2016;14:44-9.
15. Uzuner MB, Ocak M, Geneci F, et al. Quantitative and morphometric evaluation of the foramina nutricia in the long bones of the upper and lower extremities in Anatolian population. Kafkas J Med Sci. 2018;8:30-4.
16. Rangasubhe P, Sivan S. A study of nutrient foramina in dry adult radii of South Indian subjects. National Journal of Clinical Anatomy. 2014;3:71-5.
17. Rangasubhe P, Havaldar PP. An osteological study on nutrient foramina of human dry adult ulna bones. Int J Anat Res. 2019;7:6149-53.
18. Gaharwar A, Sinha P. Comparision of ulna to fibula with respect to morphology and topography of nutrient foramen. Indian Journal of Research. 2020;9:59-61.
19. Kumari R, Prasad R. Study on nutrient foramen of humerus and its clinical implication. IOSR J Dental and Med Sci. 2019;18:28-31.
20. Pankaj AK, Verma RK, Rani A, et al. Morphometric study of nutrient foramina of humerus in North Indian population. Indian J Clin Anat Physiol. 2017;4:169-72.
21. Xue Z, Ding H, Hu C, et al. An anatomical study of the nutrient foramina of the human humeral diaphysis. Med Sci Monit. 2016;22:1637-45.
22. Ghule SB, Vitore B, Mahajan AA. Anatomical study of nutrient foramina in humerus. Indian J Clin Anat Physiol. 2018;5:412-15.
23. Khandve B, Verma A. A study of nutrient foramina of humerus at chhattisgarh state. International Journal of Innovative Research in Medical Science. 2018;3:1794-8.
24. Solanke KS, Bhatnagar R, Pokhrel R. Number and position of nutrient foramina in humerus, radius and ulna of human dry bones of Indian origin with clinical correlation. OA Anatomy. 2014;2:1-4.
25. Chavda SR, Rathwa AJ, Akbari V. A study on variations of nutrient foramen of ulna in Saurashtra region with its clinical relevance. Int J Anat Res. 2018;6:5844-7.
26. Priya DC, Durga JL, Chandrupatla M. A morphological study of nutrient foramina of human ulna and their clinical importance. International Journal of Research and Review. 2019;6:75-9.
27. Singh N, Magotra R, Kumar A, Sharma AK. Morphological and morphometric study of tibial nutrient foramen. J Evol Med Dent Sci. 2015;4:6398-401.
28. Jayaprakash T. Morphologic study of diaphyseal nutrient foramina in dried fibulae and its clinical implications. Int J Res Med Sci. 2016;4:3887-90.
29. Leschinger T, Krane F, Hackl M, et al. The dominant nutrient foramen at the clavicular midshaft: An anatomical study. Surg Radiol Anat. 2019;41:361-4.
30. Kumar S, Ratnesh R, Fatima N, et al. Morphological study of nutrient foramina of human radius and their clinical importance. Int Arch Integr Med. 2017;4:105-10.
31. Sinha N, Kumar Sinha S, Singh RP. A study of anatomy of nutrient foramen of tibia. International Journal of Medical and Health Research. 2017;3:111-2.
32. Udaya Kumar P, Janardhan Rao M, Sirisha V, Kalpana T. A study of the nutrient foramina in dry human tibia bones of Telangana region. Int J Anat Res. 2017;5:4152-7.
33. Ghosh T, Ray MK. Anthropometric analysis of nutrient foramen of tibia - a study in Eastern India. International Journal of Research and Review. 2020;7:100-3.
34. Zahid A, Shakir MA, Shireen R. Morphological and topographical anatomy of diaphyseal nutrient foramina of dried Pakistani fibulae. J Coll Physicians Surg Pak. 2015;25:560-3.