Kuru femurlarda foramen nuticium'ların sayı ve lokalizasyonunun morfolojik analizi

Year 2026, Volume: 43 Issue: 1 , 26 - 30 , 01.04.2026

Tarık Can Ekici , Zeynep Akça Andı , Mehmet Emirzeoğlu , Ahmet Uzun

https://izlik.org/JA73FM86UL

Abstract

Foramen nutricium’dan geçen a. nutricium, kemiklerin büyüme ve gelişmesi için yeterli kan akışının sağlanmasında hayati bir rol oynamaktadır. Bu çalışma, vücudun en uzun kemiği olan femurun foramen nutricium sayısını ve lokalizasyonunu belirlemeyi amaçlamıştır.
Çalışmada, Ondokuz Mayıs Üniversitesi Tıp Fakültesi Anatomi Anabilim Dalı koleksiyonunda bulunan, yaşı ve cinsiyeti bilinmeyen 70 adet erişkin kuru femur (35 sağ, 35 sol) incelenmiştir. Foramenlerin açıklığını belirlemek amacıyla 20 ve 24 gauge hipodermik iğneler kullanılmıştır. Foramenlerin lokalizasyonu, femurun üst, orta ve alt üçte birlik bölgelerine göre değerlendirilmiştir. Major foramen nutricium belirlenmiş ve foraminal indeks hesaplanmıştır. Veriler SPSS v.22 yazılımı kullanılarak analiz edilmiştir.
Bulgulara göre örneklerin %35,7’sinde bir, %37,1’inde iki, %14,3’ünde üç, %4,3’ünde dört adet foramen nutricium saptanmış; %8,6’sında ise hiç foramen nutricium bulunmamıştır. Foramenlerin %33,61’i femurun üst üçte birlik kısmında, %60,5’i orta üçte birlik kısmında, %5,88’i ise alt üçte birlik kısmında yer almaktadır. Ortalama foraminal indeks 41,43 ± 12,85 olarak hesaplanmıştır. Foraminal indeks ile femur uzunluğu veya foramen nutricium sayısı arasında istatistiksel olarak anlamlı bir korelasyon saptanmamıştır (p > 0,05). Taraflar arası fark açısından sağ femurların uzunluğu sol taraftakilere göre anlamlı derecede daha yüksek bulunmuştur (p = 0,026). Ancak foraminal indeks ve foramen nutricium sayısı bakımından taraflar arasında anlamlı fark görülmemiştir (p > 0,05).
Elde edilen veriler, bu bölgede gerçekleştirilecek cerrahi girişimlerde kemik vasküler yapısının korunmasına yönelik tedavi stratejilerinin geliştirilmesinde klinisyen ve cerrahlara yol gösterebilir.

Keywords

foramen nutricium , femur , kuru kemik , foraminal indeks

Ethical Statement

Bu çalışma, kuru insan femurları üzerinde, anatomi koleksiyonundaki kemikler kullanılarak gerçekleştirilmiştir. Çalışma insan ya da hayvan denekleri içermediğinden etik kurul onayı gerekmemektedir. Bu araştırma, Dünya Tıp Birliği Helsinki Bildirgesi’nde belirtilen etik ilkelere uygun olarak yürütülmüştür.

Morphological analysis of the number and localization of nutrient foramina in dry femora

https://izlik.org/JA73FM86UL

Abstract

The nutrient artery passing through the nutrient foramen (NF) plays a vital role in ensuring that the bones receive sufficient blood for growth and development. This study aimed to determine the number and location of the NF of the femur, which is the longest bone in the body. In this study, 70 adult dry femora of unknown age and sex (35 right and 35 left) were examined at the Department of Anatomy, Faculty of Medicine, Ondokuz Mayıs University. Hypodermic needles of 20- and 24-gauge were used to determine the patency of the foramina. The localization of the foramina was evaluated based on their location in the upper, middle, and lower thirds of the femur. The major NF was identified, and the foraminal index was calculated. The data were analyzed using SPSS V.23 software. No statistically significant correlation was found between the foraminal index and femur length (r =-0.052, p =0.682), between the foraminal index and the number of NFs (r =0.007, p =0.959), or between femur length and the number of NFs (r =-0.025, p = 0.835). Regarding side differences, the bone length of the right femora was higher than that of the left side (p=0.026). The findings revealed that 35.71% of the samples had one NF, 37.14% had two NFs, 14.28% had three NFs, and 4.28% had four NFs, while 8.57% had no NF. A total of 33.61% of the NFs were located in the upper third of the femur, 60.50% in the middle third, and 5.88% in the lower third. The mean foraminal index was 41.43 ± 12.85. There were no significant differences between the sides regarding the foraminal index and number of NF (p>0.05). The data obtained can guide clinicians and surgeons in creating treatment strategies to preserve the bone vascular structure in interventions performed in this region.

Keywords

Nutrient foramina , femur , dry bone , foraminal index

Ethical Statement

Ethical statement This study was conducted on dry human femora using the bone collection, ethics committee approval was not required. This study adhered to the World Medical Association Declaration of Helsinki.

References

• Trueta J. Blood supply and the rate of healing of tibial fractures. Clin Orthop Relat Res. 1974;(105):11–26.
• Tomlinson RE, Silva MJ. Skeletal blood flow in bone repair and maintenance. Bone Res. 2013;1(1):311–322.
• Thakur UP, Yadav PK, Sah BK, Prasad RJ, Shah TN. Topography and indexing of the nutrient foramina of the adult long bones. Nepal Med Coll J. 2023;25(3):259–264.
• Prashanth KU, Murlimanju BV, Prabhu LV, Kumar CG, Pai MM, Dhananjaya KVN. Morphological and topographical anatomy of nutrient foramina in the lower limb long bones and its clinical importance. Australas Med J. 2011;4(10):530-7.
• Mazengenya P, Mokoena P, Billings BK, Manjatika AT. Topographic and morphometric characterization of the humerii nutrient foramina and their implications for fracture repair and healing. Sci Rep. 2025;15(1):2939.
• Laroche M. Intraosseous circulation from physiology to disease. Joint Bone Spine. 2002;69(3):262-9.
• Kawasaki Y, Kinose S, Kato K, Sakai T, Ichimura K. Anatomic characterization of the femoral nutrient artery: Application to fracture and surgery of the femur. Clin Anat. 2020;33(4):479-87.
• Filipowska J, Tomaszewski KA, Niedźwiedzki Ł, Walocha JA, Niedźwiedzki T. The role of vasculature in bone development, regeneration and proper systemic functioning. Angiogenesis. 2017;20(3):291-302.
• Campos FF, Pellico LG, Alias MG, Fernandez-Valencia R. A study of the nutrient foramina in human long bones. Surg Radiol Anat. 1987;9(3):251-5.
• Marenzana M, Arnett TR. The key role of the blood supply to bone. Bone Res. 2013;1(1):203-15.
• 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(1):87-95.
• Mughal AM, Hassan STU, Sabir B, Raja HAA, Ahmad SM. A descriptive correlational study of vascular foramina in adult human femora in cadavers in Pakistan. J Islamabad Med Dent Coll. 2023;12(2).
• Brandi ML, Collin-Osdoby P. Vascular biology and the skeleton. J Bone Miner Res. 2006;21:183-92. Shulman SS. Observations on the nutrient foramina of the human radius and ulna. Anat Rec. 1959;134:685-97.
• Craig JG, Widman D, van Holsbeeck M. Longitudinal stress fracture: patterns of edema and the importance of the nutrient foramen. Skeletal Radiol. 2003;32:22-7.
• Kumar S, Prasad R, Sinha R. Morphometric study of the nutrient foramen of the humerus in the population of Bihar. Cureus. 2022;14:e32856.
• Klenerman L. Fractures of the shaft of the humerus. J Bone Joint Surg Br. 1966;48:105-11.
• Gupta AK, Ambekar M. Study Of Nutrient Foramina In Adult Human Femur Bones. Journal of Nepalgunj Medical College. 2018;14:44-9.
• Ambekar SA, Gajbe UL, Avate AN. Diaphyseal nutrient foramen of lower limb long bones: variations and importance. Int J Anat Res. 2016;4:2684-2688.
• Kudopa A, Marskole S, Quadir N, Agrawal R. Morphometric and topographical study of the nutrient foramina in femur of central Indian population. Int J Med Public Health. 2024;14(1):38-43.
• Zahra SU, Kervancioglu P, Bahsi I. Morphological and topographical anatomy of nutrient foramen in the lower limb long bones: Alt ekstremite uzun kemiklerinde foramen nutricium’ların morfolojik ve topografik anatomisi. Anat J. 2018;24:36-43.
• Longia GS, Ajmani ML, Saxena SK, Thomas RJ. Study of diaphyseal nutrient foramina in human long bones. Acta Anat (Basel). 1980;107:399-406.
• Afzal E, Sherin F, Wazir AH, Marwat ZI,Khan MJ, Wazir AK. Determination of the Positions of the Nutrient Foraminaein the Human Adult Lower Limb Long Bones. Med Forum 2019;30(3):66-70.
• Gümüsburun E, Yücel F, Ozkan Y, Akgün Z. A study of the nutrient foramina of lower limb long bones. Surg Radiol Anat. 1994;16(4):409-12.
• Dervišević L, Dervišević A, Ajanović Z, Hasanbegović I, Hadžihalilović AS, Kapur E, et al. Correlation of Long Bone Length and Number of Nutrient Foramina – Importance in Everyday Clinical Practice. J. Pharm. Res. Int. 2021;33(61A):33-41.
• Aggarwal P, Roy R, Medda S. Variations in nutrient foramen in the long bones of lower limb. Indian Journal of Clinical Anatomy and Physiology 2022;9(1):35–41.
• Sendemir E, Cimen A. Nutrient foramina in the shafts of lower limb long bones: situation and number. Surg Radiol Anat. 1991;13(2):105-8.
• Shrestha P, Mansur DI, Mehta DK, Shrestha S, Shrestha A. A Study on Variations of Nutrient Foramen of Femur and its Clinical Implications. Journal of Lumbini Medical College. 2019;7(2):61-64.
• Roshini N, Yuvaraj MF, Kasirajan SP, Karunakaran B, Govindan L, Caleb JTD, Sivalingam AM, Siva T, Kumar S. Nutrient foramina of human fibula: morphometric analysis and clinical relevance. J Bone Miner Metab. 2025;43(2):149-157.
• Anetai H, Kinose S, Sakamoto R, Onodera R, Kato K, Kawasaki Y et al. Anatomic characterization of the tibial and fibular nutrient arteries in humans. Anat Sci Int. 2021;96(3):378-385.
• Paslı B, Ülkir M, Günenç Beşer C. Morphometric, morphologic and topographic evaluation of diaphyseal nutrient foramina of the femur. Surg Radiol Anat. 2025;47(1):102.
• Hughes H. The factors determining the direction of the canal for the nutrient artery in the long bones of mammals and birds. Acta Anat (Basel). 1952;15(3):261-80.
• Mysorekar VR. Diaphysial nutrient foramina in human long bones. J Anat. 1967;101(Pt 4):813-22.