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International Journal of Trend in Scientific Research and Development (IJTSRD)
Volume 5 Issue 4, May-June 2021 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470
@ IJTSRD | Unique Paper ID – IJTSRD42607 | Volume – 5 | Issue – 4 | May-June 2021 Page 1513
Reporting a Giant Diaphyseal Nutrient
Foramen in a Dried Right Femur
Dr. Neelima. P1, Dr. Ravi Sunder2
1Professor & HOD Anatomy, NRIIMS, Visakhapatnam, Andhra Pradesh, India
2Professor & HOD Physiology, GIMSR, Visakhapatnam, Andhra Pradesh, India
ABSTRACT
Nutrient foramen convey the vascular supply to the long bones. Anomalies in
the morphology of nutrient foramen is crucial in understanding bone
pathologies and operative procedures. Though extensive research has been
done on the morphology and morphometry of normal nutrient foramina,
literature was scanty on the abnormal nutrientforamenonfemur.Thepresent
study reports a giant diaphyseal nutrientforamen encounteredina driedright
femur. On routine observation of dried femora from the department of
anatomy, one right sided femur exhibitedanabnormal nutrientforameninthe
shaft over the linea aspera. It measured 4.2 x 1.3 cms. The foramen was
continued as a canal on the exterior of the bone near the upper end of linea
aspera. The foramen proper had a radius of 1.4cms. Photographs were taken.
All other foramina were found to be normal. The nutrient artery might be
enlarged enormously while passing through this foramen converting it into a
canal on the exterior itself. Understanding such anomalies is essential in
dealing with conditions like micro vascular bone graft or internal fixation or
fracture healing or non union or malunion as these are dependant on proper
blood supply to the bone. The abnormal nutrient foramen may cause
disturbances in the blood flow. The present study reports a rare anomaly of
nutrient foramen over the linea aspera of a right sided femur.
KEYWORDS: Giant nutrient foramen, femur, linea aspera, diaphysis
How to cite this paper: Dr. Neelima. P |
Dr. Ravi Sunder "Reporting a Giant
Diaphyseal Nutrient Foramen in a Dried
Right Femur"
Published in
International Journal
of Trend in Scientific
Research and
Development(ijtsrd),
ISSN: 2456-6470,
Volume-5 | Issue-4,
June 2021, pp.1513-1514, URL:
www.ijtsrd.com/papers/ijtsrd42607.pdf
Copyright © 2021 by author (s) and
International Journal ofTrendinScientific
Research and Development Journal. This
is an Open Access article distributed
under the terms of
the Creative
Commons Attribution
License (CC BY 4.0)
(http: //creativecommons.org/licenses/by/4.0)
INTRODUCTION
Long bones receive their vascular supply through nutrient
arteries passing through an obliquely placed nutrient
foramen persistently seen on the shaft. They provide blood
supply to the whole medulla and inner 2/3rds of the cortex
(1). During ossification in the early growth of the embryo,the
vascular supply is essential which is determined by their
location and number (2). As stated by A.K.Datta (3) the
direction of nutrient foramen follows the dictum “to the
elbow I go and away from the knee I flee” and this is due to
diffential growth of two ends of the long bone. Mammalian
bones were studied by Henderson (4) illustratingtheposition
and number of nutrient foramen. Malukar etal (5) evaluated
miniature long bones for the nutrient foramina. The
physiological importance of blood supply of long bones in
fracture healing, union and abnormalities like malunionand
nonunion were described by Robert (6). Many studies have
been done on the nutrient foramina of long bones. The
morphology of nutrient foramendeterminestheefficiencyof
the blood supply to the bone. Femur, the strongest and
longest bone of the human bodyneedsa properbloodsupply
through a perfect nutrient foramen. Literature is scanty
regarding the abnormal presentation of a nutrient foramen
on femur. The present study has been done to report a very
rare case of a dried femur with giant nutrientforamenonthe
superior part of linea aspera.
MATERIALS & METHODS
On routine examination of dried femora from the
department of Anatomy, one femur was observed to show a
giant nutrient foramen on the superioraspectoflinea aspera
on the shaft of femur. Its dimensions were measured with a
vernier callipers.Thebone wasexaminedforotherforamina.
Photographs were captured and thouroughly evaluated.
RESULTS
Fig 1: posterior aspect of right femur with giant
nutrient foramen
IJTSRD42607
International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD42607 | Volume – 5 | Issue – 4 | May-June 2021 Page 1514
Fig 2: giant nutrient foramen on the diaphysis of right
femur lateral view
Fig 3: giant nutrient foramen with bevelled edge and
external canal
A giant nutrient foramen measuring 4.2 x 1.3 cms has been
observed on the superior aspect of linea aspera of right
femur. The margins of the foramen were bevelled and
serrated and had a radius of 1.4 cms. The foramen was
extended as a canal visible on the exterior of the bone.
DISCUSSION
Nutrient foramen on the femur is located on the linea aspera
which lies on the posterior aspect of the shaft. Blood supply
determines the effective healing of fractures as describedby
Johnson (7). The osteoblast and osteocyte survival facilitates
graft healing in the recipient as stated by Craig etal (8).
Priyanka etal (9) studied on clavicles and reported that
Knowledge about the variations of nutrient foramen help to
select the prosthesis for internal fixation. The importance of
nutrient foramen in osseous selection levels of the receptor
in bone transplantation was putforth by Wavreille etal (10).
Though the size appears small, the crucial role of the
nutrient foramen has been described in various studies.
Many authors have studied on the morphology and
morphometry of nutrientforamina oflongbones.Butstudies
on abnormal nutrient foramen of femur were almostnil. The
present study demonstrates a rare anomaly of nutrient
foramen. Femur is the weight bearing bone of the body
which requires a proper blood supply through a perfect
nutrient foramen. Anomalies of the morphology of nutrient
foramen could be the underlying cause of various
pathologies. Knowledge about the variant anatomy of the
nutrient foramen is helpful while performing operative
procedures like bone graft or prosthesis or internal fixation.
This study presents an extreme anomaly of a giant nutrient
foramen in the right femur.
CONCLUSION
A giant nutrient foramen leading into an external canal has
been reported on the superior aspect of linea aspera of a
right sided dried femur. It is one of the rarest presentations.
REFERENCES
[1] Gray's Anatomy. The anatomical basis of clinical
practice. Standring S, Healy JC, Johnson D, CollinsP,et
al, London: Elsevier Churchill Livingstone 2005;
40th ed:871.
[2] Kizilkanat E, Boyan N, Ozsahin ET, et al. Location,
number and clinical significance of nutrient foramina
in human long bones. Ann Anat 2007; 189(1):87-95.
[3] Principles of general anatomy. AsimKumarDutta,the
Blood supply of bones 2013; 7th ed: 58,75,76.
[4] Henderson RG The positionofthenutrientforamenin
the growing tibia and femur of the rat. J Anat. 1978
Mar; 125(Pt 3):593-9.
[5] Malukar O, Joshi H. Diaphyseal nutrient foramina in
long bones and miniature long bones. NJIRM 2011;
2(2):23-26.
[6] Robert WA, A physiological study of the blood supply
of the diaphysis J Bone Joint surg 1927 9:153-54.
[7] Johnson RW, A Physiological study of the Blood
Supply of the Diaphysis Journal of Bone & Joint
Surgery 1927 9:153
[8] Craig JG, Widman D, van Holsbeeck M. Longitudinal
stress fracture: patterns ofedema andtheimportance
of the nutrient foramen. Skeletal Radiol 2003;
32(1):22-27.
[9] Priyanka Sinha, Suniti Raj Mishra, Pramod Kumar, et
al. Morphometric & topographic study of nutrient
foramen in human clavicle in India. Int J Biol Med Res
2015; 6(3):5118-5121.
[10] Wavreille G, Dos Remédios C, Chantelot C, et al
Anatomic bases of vascularized elbow joint
harvesting to achieve vascularized allograft. Surg
Radiol Anat 2006; 28(5):498-510.

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Giant nutrient foramen in dried femur

  • 1. International Journal of Trend in Scientific Research and Development (IJTSRD) Volume 5 Issue 4, May-June 2021 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470 @ IJTSRD | Unique Paper ID – IJTSRD42607 | Volume – 5 | Issue – 4 | May-June 2021 Page 1513 Reporting a Giant Diaphyseal Nutrient Foramen in a Dried Right Femur Dr. Neelima. P1, Dr. Ravi Sunder2 1Professor & HOD Anatomy, NRIIMS, Visakhapatnam, Andhra Pradesh, India 2Professor & HOD Physiology, GIMSR, Visakhapatnam, Andhra Pradesh, India ABSTRACT Nutrient foramen convey the vascular supply to the long bones. Anomalies in the morphology of nutrient foramen is crucial in understanding bone pathologies and operative procedures. Though extensive research has been done on the morphology and morphometry of normal nutrient foramina, literature was scanty on the abnormal nutrientforamenonfemur.Thepresent study reports a giant diaphyseal nutrientforamen encounteredina driedright femur. On routine observation of dried femora from the department of anatomy, one right sided femur exhibitedanabnormal nutrientforameninthe shaft over the linea aspera. It measured 4.2 x 1.3 cms. The foramen was continued as a canal on the exterior of the bone near the upper end of linea aspera. The foramen proper had a radius of 1.4cms. Photographs were taken. All other foramina were found to be normal. The nutrient artery might be enlarged enormously while passing through this foramen converting it into a canal on the exterior itself. Understanding such anomalies is essential in dealing with conditions like micro vascular bone graft or internal fixation or fracture healing or non union or malunion as these are dependant on proper blood supply to the bone. The abnormal nutrient foramen may cause disturbances in the blood flow. The present study reports a rare anomaly of nutrient foramen over the linea aspera of a right sided femur. KEYWORDS: Giant nutrient foramen, femur, linea aspera, diaphysis How to cite this paper: Dr. Neelima. P | Dr. Ravi Sunder "Reporting a Giant Diaphyseal Nutrient Foramen in a Dried Right Femur" Published in International Journal of Trend in Scientific Research and Development(ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4, June 2021, pp.1513-1514, URL: www.ijtsrd.com/papers/ijtsrd42607.pdf Copyright © 2021 by author (s) and International Journal ofTrendinScientific Research and Development Journal. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (http: //creativecommons.org/licenses/by/4.0) INTRODUCTION Long bones receive their vascular supply through nutrient arteries passing through an obliquely placed nutrient foramen persistently seen on the shaft. They provide blood supply to the whole medulla and inner 2/3rds of the cortex (1). During ossification in the early growth of the embryo,the vascular supply is essential which is determined by their location and number (2). As stated by A.K.Datta (3) the direction of nutrient foramen follows the dictum “to the elbow I go and away from the knee I flee” and this is due to diffential growth of two ends of the long bone. Mammalian bones were studied by Henderson (4) illustratingtheposition and number of nutrient foramen. Malukar etal (5) evaluated miniature long bones for the nutrient foramina. The physiological importance of blood supply of long bones in fracture healing, union and abnormalities like malunionand nonunion were described by Robert (6). Many studies have been done on the nutrient foramina of long bones. The morphology of nutrient foramendeterminestheefficiencyof the blood supply to the bone. Femur, the strongest and longest bone of the human bodyneedsa properbloodsupply through a perfect nutrient foramen. Literature is scanty regarding the abnormal presentation of a nutrient foramen on femur. The present study has been done to report a very rare case of a dried femur with giant nutrientforamenonthe superior part of linea aspera. MATERIALS & METHODS On routine examination of dried femora from the department of Anatomy, one femur was observed to show a giant nutrient foramen on the superioraspectoflinea aspera on the shaft of femur. Its dimensions were measured with a vernier callipers.Thebone wasexaminedforotherforamina. Photographs were captured and thouroughly evaluated. RESULTS Fig 1: posterior aspect of right femur with giant nutrient foramen IJTSRD42607
  • 2. International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD42607 | Volume – 5 | Issue – 4 | May-June 2021 Page 1514 Fig 2: giant nutrient foramen on the diaphysis of right femur lateral view Fig 3: giant nutrient foramen with bevelled edge and external canal A giant nutrient foramen measuring 4.2 x 1.3 cms has been observed on the superior aspect of linea aspera of right femur. The margins of the foramen were bevelled and serrated and had a radius of 1.4 cms. The foramen was extended as a canal visible on the exterior of the bone. DISCUSSION Nutrient foramen on the femur is located on the linea aspera which lies on the posterior aspect of the shaft. Blood supply determines the effective healing of fractures as describedby Johnson (7). The osteoblast and osteocyte survival facilitates graft healing in the recipient as stated by Craig etal (8). Priyanka etal (9) studied on clavicles and reported that Knowledge about the variations of nutrient foramen help to select the prosthesis for internal fixation. The importance of nutrient foramen in osseous selection levels of the receptor in bone transplantation was putforth by Wavreille etal (10). Though the size appears small, the crucial role of the nutrient foramen has been described in various studies. Many authors have studied on the morphology and morphometry of nutrientforamina oflongbones.Butstudies on abnormal nutrient foramen of femur were almostnil. The present study demonstrates a rare anomaly of nutrient foramen. Femur is the weight bearing bone of the body which requires a proper blood supply through a perfect nutrient foramen. Anomalies of the morphology of nutrient foramen could be the underlying cause of various pathologies. Knowledge about the variant anatomy of the nutrient foramen is helpful while performing operative procedures like bone graft or prosthesis or internal fixation. This study presents an extreme anomaly of a giant nutrient foramen in the right femur. CONCLUSION A giant nutrient foramen leading into an external canal has been reported on the superior aspect of linea aspera of a right sided dried femur. It is one of the rarest presentations. REFERENCES [1] Gray's Anatomy. The anatomical basis of clinical practice. Standring S, Healy JC, Johnson D, CollinsP,et al, London: Elsevier Churchill Livingstone 2005; 40th ed:871. [2] Kizilkanat E, Boyan N, Ozsahin ET, et al. Location, number and clinical significance of nutrient foramina in human long bones. Ann Anat 2007; 189(1):87-95. [3] Principles of general anatomy. AsimKumarDutta,the Blood supply of bones 2013; 7th ed: 58,75,76. [4] Henderson RG The positionofthenutrientforamenin the growing tibia and femur of the rat. J Anat. 1978 Mar; 125(Pt 3):593-9. [5] Malukar O, Joshi H. Diaphyseal nutrient foramina in long bones and miniature long bones. NJIRM 2011; 2(2):23-26. [6] Robert WA, A physiological study of the blood supply of the diaphysis J Bone Joint surg 1927 9:153-54. [7] Johnson RW, A Physiological study of the Blood Supply of the Diaphysis Journal of Bone & Joint Surgery 1927 9:153 [8] Craig JG, Widman D, van Holsbeeck M. Longitudinal stress fracture: patterns ofedema andtheimportance of the nutrient foramen. Skeletal Radiol 2003; 32(1):22-27. [9] Priyanka Sinha, Suniti Raj Mishra, Pramod Kumar, et al. Morphometric & topographic study of nutrient foramen in human clavicle in India. Int J Biol Med Res 2015; 6(3):5118-5121. [10] Wavreille G, Dos Remédios C, Chantelot C, et al Anatomic bases of vascularized elbow joint harvesting to achieve vascularized allograft. Surg Radiol Anat 2006; 28(5):498-510.