The Diaphyseal nutrient foramina architecture - a study on the human upper and lower limb long bones

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1 IOSR Journal of Pharmacy and Biological Scincs (IOSR-JPBS) -ISSN: , p-issn: Volum 9, Issu 1 Vr. III (Jan. 2014), PP Th Diaphysal nutrint foramina architctur - a study on th human uppr and lowr limb long bons Dr. Shamsundr Rao V, Jyothinath Kothapalli Profssor& HOD, Dpartmnt of Anatomy, MNR mdical collg& hospital, Sangarddy, Mdak, Andhrapradsh Assistant lcturr, Dpartmnt of Anatomy, MNR mdical collg& hospital, Sangarddy, Mdak, Andhrapradsh Corrsponding author: Abstract: Th nutrint foramina ar cavitis that conduct th nutrint artris and th priphral nrvs on th shaft of long bons. Long bons rciv most of th introssous blood supply from th nutrint artris, and somtims through th priostal vssls. Nutrint artris play an important rol in nutrition and growth of th bons particularly during its growth priod in th mbryo and ftus as wll as during arly phass of ossification. Th prsnt study was conductd in th dpartmnt of Anatomy, MNR Mdical collg, Sangarddy, Mdak, Andhra Pradsh and Govt. Mdical Collg, Aurangabad, Maharashtra. A study group comprisd of 1320 (840mal, 480 fmal) long bons of uppr and lowr limbs of known ag and sx from th bon library. Th numbr, location, dirction, position and also whthr th nutrint foramina oby th gnral rul that is dirctd away from th growing nd of long bon is dtrmind in this study. Distanc of nutrint foramina from ithr nds of long bons ar mor in mals than fmals. Singl nutrint foramn is common in fmals whras multipl nutrint foramna in mals. Fmur showd highst numbr of nutrint foramna in 2 nd sgmnt in mals and fmals only 1% shows multipl nutrint foramns in scond sgmnt. Two nutrint foramns wr found in 68% of fmur, 14% of tibia, 20% of fibula and only 10% of Humrus whil it is lss in fmals. Kywords: Nutrint Foramn, Diaphysis, Long Bon, Sgmnts of long bon. I. Introduction Th nutrint foramn is dfind as th largst of th foramn prsnt on th shaft of long bon allowing nutrint artry to ntr th bon, th rol of which is important in providing nutrition and growth of long bons [1]. Thir dirction follows a gnral adult rul towards th kn and away from lbow I fl. Th nutrint foramn is distinguishd from any othr foramn by th prsnc of distinct vascular groov outsid th nutrint foramn. Th dirction of nutrint canal is important to dnot th growing nd of a bon [2, 3]. Th xtrnal opning of th nutrint canal, usually rfrrd to as th nutrint foramn, has a particular position for ach bon [4]. Longia GS t al. [5] obsrvd that th position of nutrint foramina was on th flxor aspct in thir human long bon spcimns. It is gnrally agrd that th vssls which occupy th nutrint foramn ar drivd from thos that took part in th initial invasion of th ossifying cartilag, so that th nutrint foramn was at th sit of original cntr of ossification [4, 5]. Study of rlativ rlationship btwn th lngth of bon and distanc of nutrint foramn from ithr nds is usful in calculating th lngth of a long bon from a givn fragmnt, which is important in mdico-lgal and anthropological work. From th lngth of th long bons hight of an individual can b rconstructd [5]. An undrstanding of th location and th numbr of th nutrint foramina in long bons is thrfor important in orthopdic surgical procdurs such as joint rplacmnt thrapy, fractur rpair bon grafts and vascularizd bon microsurgry as wll as mdico lgal cass. In fr vascular bon grafting, th nutrint blood supply is xtrmly important and must b prsrvd to promot fractur rpair, a good blood supply bing ncssary for ostoblast and ostocyt cll survival, as wll as facilitating graft haling in th rcipint [5, 6]. Larg numbr of studis has bn mad to dtrmin th numbr, position and dirction of nutrint foramn and also thir distanc from th nds of th long bons. Most of ths studis hav compard th data of th right and lft but no attmpt was mad to find out if thr is any sx diffrnc in it. Th prsnt study has bn undr takn with th aim of carrying out xtnsiv study of th nutrint foramn in human long bons of both sxs. Th numbr, position, dirction, its distanc from th nds and th diamtr of shaft at th sit of nutrint foramn is bing studid, analyzd and discussd. 36 Pag

2 II. Matrials and Mthods For th prsnt study a total 1320 long bons of known ag and sx blonging to th skltal collction of th dpartmnt of anatomy, MNR Mdical Collg, Sangarddy, Mdak, Andhra Pradsh and Govt. mdical collg, Aurangabad, Maharashtra takn for th study. Mal and fmals bons wr studid sparatly. Exclusion critria: bons with dformitis and fracturd bons ar xcludd from this study Following long bons wr takn for th prsnt study 1. Fmur 2. Tibia 3. Fibula 4. Humrus 5. Radius 6. Ulna Following paramtrs wr studid in mal and fmals and tabulatd sparatly for th prsnt study: 1. Total lngth: lngth of ach long bon was masurd with Ostomtric board. 2. Numbr of nutrint foramn: with magnifying lns. 3. Dirction and obliquity of nutrint foramn 4. Distanc of nutrint foramn from uppr nd: masurd with Vrnir caliprs. 5. Distanc of nutrint foramn from lowr nd: masurd with Vrnir caliprs. 6. Antro-postrior diamtr of th shaft: masurd with Vrnir caliprs. 7. Mdio-latral diamtr of th shaft: masurd with Vrnir caliprs. 8. Position of nutrint foramn according to th sgmnts: To locat th xact position of nutrint foramn and to study its dirction, th shaft of ach long bon was dividd in to various sgmnts. First total lngth of ach long bon was masurd by Ostomtric board thn it was dividd into various qual sgmnts by Vrnir caliprs. For th sak of convninc Humrus and fmur wr dividd in to 6 sgmnts whil othr bons viz. radius, ulna, tibia, fibula wr dividd in to 3 sgmnts. In ach sgmnt th nutrint foramn was sarchd with hand lns (Fig 1&2). Instrumnts usd for th study: 1. Hand lns: usd to locat nutrint foramina. 2. Ostomtric board: usd to masur th lngth of long bons. 3. Vrnir caliprs: usd to masur diamtr of th long bons. Mal and fmal long bons wr studid sparatly. At th first instanc ths masurmnts wr tabulatd and statistically analyzd. III. Rsult Tabl 1: showing man valus of various paramtrs of long bons in mal and fmal Bons Total lngth Distanc from uppr nd to N.F Distanc from lowr nd to N.F A-P diamtr of N.F Mdio-latral diamtr at N.F Humrus Radius Ulna Fmur Tibia Fibula Tabl.1 shows maximum lngth in fmur 43.43cm in mals th last lngth was in radius in 24.59cm. In fmals fmur showd 40.32cm whil radius showd 22.30cm. This sxual variation is statistically significant. Excpt in tibia and fibula and in othr long bons th distanc of nutrint foramina from uppr nd is found to b significant. Highst valu of distanc of nutrint foramina from lowr nd is rportd in fmur 29.8 cm in mals and fmals 27.8 cm. last valus wr sn in Humrus (12.58 in mals and in fmals 11.99cm). Whil ulna and fmur did not show significant diffrnc in ithr sx. Mdio-latral and antro-postrior diamtr at nutrint foramina showd highr valus in mals than in fmals xcpt in tibia. 37 Pag

3 Tabl 2: showing prcntag of incidnc of nutrint foramina in long bons Bons On N.F (%) Two N.F (%) Thr N.F (%) Humrus Radius Ulna Fmur Tibia Fibula Tabl 2 shows that numbr of nutrint foramina in long bons wr variabl. Most of th bons having only on nutrint foramn, but th fmur showd prsnc of 3 nutrint foramina (mals 15%, fmals1%). Prsnc of two nutrint foramina wr obsrvd in Humrus (mals10%, fmals2%), in fibula (mals 20%, fmals5%). Tabl 3: showing th position of nutrint foramina in ach sgmnt of long bons Bons 1 st sgmnt 2 nd sgmnt 3 rd sgmnt 4 th sgmnt 5 th sgmnt 6 th sgmnt Mal Fmal Mal fma l Humrus Radius Ulna Fmur Tibia Fibula For locating th position of nutrint foramina th bons wr dividd in to 3 sgmnts xcpt fmur and Humrus which wr dividd in to 6 sgmnts (Fig1 & 2). In Humrus nutrint foramina was found in 4 th sgmnt in mals and fmals (112 and 72). In radius nutrint foramina was found in 1 st sgmnt in mals130 and in fmals 80. In ulna nutrint foramina is qually distributd in 1 st and 2 nd sgmnt in mals, whil in fmal it is found mor in 1 st sgmnt than 2 nd sgmnt (tabl3). In fmur 2 nd and 4 th sgmnt showd highr numbr of nutrint foramina in both sxs (mals 152/90, fmals 75/24) rspctivly (tabl3). In tibia nutrint foramina is constant in position in 1 st sgmnt on vrtical lin (147 in mals and 80 in fmals). Fibula showd mor numbr of nutrint foramina in 2 nd sgmnt of both sxs (mal168 and fmal 66) (tabl3). 38 Pag

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5 IV. Discussion In mbryonic priod all th nutrint artris cours caudally. This is tru in hmodynamic point of viw to forc th blood from cphalic to caudal sid. This agrs with adult ruls towards th kn and away from lbow. This is said to b du to unqual growth of th nds of th long bons. Th arrangmnt of diaphysal nutrint foramn in long bons usually follows a dfinit pattrn. Position is constant and sn on flxor surfacs. Th dirction of nutrint foramina in human long bons is dirctd away from th growing nd. This is du to on nd of long bon is growing fastr than th othr nd. In many ttra pods, thr is variation in th dirctions of nutrint foramina, but in mammals and birds Hughs pointd out that Anomalous canal ar frqunt, spcially in fmur [10]. Location of nutrint foramn in diffrnt sgmnts of long bons: a) Humrus: Mysorkar rportd th nutrint foramn in Humrus along th mdial bordr in 4 th sgmnt. Th prsnt study corrlats with this study (Fig.1). b) Radius: Mysorkar rportd nutrint foramn in 2 nd sgmnt, whil in prsnt study nutrint foramn is found in 1 st sgmnt in both sx (Fig.1). c) Ulna: th nutrint foramina wr having qual distribution in 1 st, 2 nd sgmnts, antrior surfac and antrior bordr of th shaft which corrlats with th findings of Mysorkar (Fig.1). d) Fmur: In fmur th position of th nutrint foramina showd much variability. Mysorkar quotd highr numbr of nutrint foramna in 3 rd and 4 th sgmnt whil in prsnt study it is prvalnt in 2 nd, 3 rd and 4 th sgmnts. This diffrnc may b du to gographical variation (Fig.2). ) Tibia: tibia showd most consistncy in position of nutrint foramina. It was constantly prsnt in th 1 st sgmnt of th shaft and mor commonly on vrtical lin and lss commonly latral to th vrtical lin. Th prsnt study corrlats with th study of Mysorkar (Fig.2). f) Fibula: fibula showd prsnc of nutrint foramina in 2 nd sgmnt and on th mdial crst of th bon. Th prsnt study corrlats with study of Mysorkar (Fig.2). Dirction of nutrint canal: Dirction and obliquity of nutrint canal shows th gnral pattrn i.. towards th kn and away from th lbow. All th upwardly dirctd foramina wr situatd much blow th middl of th shaft of th bon. Thr was no chang in th obliquity of th canal whn th foramina wr situatd in th cntr of th bon compard to whn thy wr narr th nds. Th foramina in th tibia wr most obliqu ons, so much so that thy wr practically vrtical. In fmur, foramina wr last obliqu as compard to othr bons. 1. Total lngth of bon is mor in mals than in fmals in all th long bons studid. Fmur has th maximum lngth of 43.43cm in mals and in fmals. Whras th radius has minimum of th lngth i.. mal 24.59cm and fmal cm. 2. Th distanc of th nutrint foramna from ithr nds of th bons ar mor in mals than fmals in all th bons. In fmur in mals th distanc from th uppr nd to th nutrint foramna is cm. in fmals 19.89cm. Th distanc of nutrint foramn from th lowr nd in cas of mals is cm whil in fmals it is 20.48cm. 3. Antro-postrior diamtr of th shaft at th sit of nutrint foramn is mor in all mal bons than th fmals. 4. Th Mdio-latral diamtr of th shaft at th nutrint foramn is mor in all mal long bons than in fmals. 5. Singl nutrint foramn is common in fmals whras multipl numbrs of foramina ar common in mals. Prcntag of nutrint foramn in long bons: 1. Fmur in mals shows highst incidnc of multipl foramina (15%). Ths ar prsnt on th mdial sid of lina aspra. Th location is ithr in 2 nd sgmnt (58.5%) or in 4 th sgmnt (32.8%). In fmals th fmur shows only 1% of thr nutrint foramina. Th sit for th occurrnc of th nutrint foramn is on th lina aspra in 2 nd sgmnt (74%) and in 4 th sgmnt (26.1%). 2. Th incidnc of occurrnc of 2 nutrint foramina is 10% in Humrus, 60% in fmur, 14% in tibia and 20% in fibula of mal bons. Whil it is comparativly lss in fmals. 3. Th position of nutrint foramn in Humrus is confind to th 4 th sgmnt in ithr sxs (mals 68.6% and fmals84%). It was prsnt on th mdial bordr and antro-mdial surfac in ithr sx. 4. Radius shows nutrint foramn in 1 st sgmnt and on antrior bordr (mals 92% and fmals 99%). 40 Pag

6 5. Ulna shows nutrint foramn in 1 st sgmnt and on antrior surfac in fmals (95%), whil in mals it is prsnt in 2 nd sgmnt and antrior bordr (51%). 6. Tibia shows constant position of nutrint foramn on th vrtical lin in 1 st sgmnt in ithr sx. In mals 75% of foramina wr found on a vrtical lin but in fmals th incidnc of foramina on vrtical lin is 56%. 7. Fibula shows common position of nutrint foramn in 2 nd sgmnt and on th mdial crst of th bon in ithr sx. Comparison of prsnt study with th prvious study: 1. Chatrapati and Mishra found th total lngth of Humrus as 31.4cm which corrlats with prsnt study i cm.distanc of nutrint foramn from uppr nd is 18.14cm and that of lowr nd is 13.44cm similar findings wr found in prsnt study i cm and cm rspctivly. 2. In radius distanc of nutrint foramn from lowr nd is cm (Chatrapati) and prsnt study cm. 3. In ulna and tibia th lngth of th bons and distanc of nutrint foramn from th nds showd qual valus in prsnt study with th study of Chatrapati and Mishra. V. Conclusion Distanc of nutrint foramna from ithr nds of long bons ar mor in mals than fmals. Singl nutrint foramn if common in fmals whras multipl nutrint foramna in mals. Fmur showd highst numbr of nutrint foramna in 2 nd sgmnt in mals and fmals only 1% shows multipl nutrint foramns in scond sgmnt. Two nutrint foramns wr found in 68% of fmur, 14% of tibia, 20% of fibula and only 10% of Humrus whil it is lss in fmals. In Humrus nutrint foramna locatd in 4 th sgmnt in both sxs. Tibia shows constant position of nutrint foramn in 1 st sgmnt and th nutrint canal is most obliqu on and obliquity is mor whn nutrint foramna is situatd towards th nds. Rfrncs [1]. Gray s- A txt book of human anatomy, 38 th dition.pag 257. [2]. Kat B.R, nutrint foramina in human long bons, J. Anat. Soc. Of India, 1970; 20, 141. [3]. LutknPoul. Invstigation into position of nutrint foramn & dirction of th vssl canals in th shaft of th humrus and fmur in man. Acta. Anat.1950; 9: [4]. Payton CG, Th position of th nutrint foramn and dirction of th nutrint canal in th long bons of th maddr-fd pig, J Anat, 1934, 68(Pt 4): [5]. Longia GS, Ajmani ML, Saxna SK, Thomas RJ, Study of diaphysal nutrint foramina in human long bons, ActaAnat (Basl), 1980, 107(4): [6]. Al-Motabagoni. Th artrial architctur of th human fmoral Diaphysis. J. Anat. Soc. India 2002; 51(1): [7]. Craig, J.G., Widman, D., van Holsbck, M. Longitudinal strss fractur: pattrns of dma and th importanc of th nutrint foramn. Skltal Radiol. 2003; 32: [8]. Chatrapathi.D.N, Mishra.B.D. Positions of nutrint foramn on th shaft of th human long bons. Journal of Anatomical socity of India, Jun 1965; 14: [9]. Mysorkar VR. Diphysial nutrint foramina in human long bons. J Anat. 1967; 101(4): [10]. Hughs, H. Th factors dtrmining th dirction of th canal for th nutrint artry in th long bons of mammals and birds. Acta Anat., 15:261-80, Pag