title: Morphological and topographical anatomy of nutrient foramina in the lower limb long bones and its clinical importance.
abstract: BACKGROUND
  Knowledge regarding nutrient foramina of bones is useful in surgical procedures such as microvascular bone transfer in order to preserve the circulation. The objective of the present study was to study the morphology and topography of nutrient foramina and to determine the foraminal index of the lower limb long bones to provide detailed data on such features.
  
  
  METHODS
  The study comprised examination of 206 lower limb long bones which included femora, tibiae and fibulae. The nutrient foramina were identified analysed macroscopically and the foramen index calculated. Each bone was divided into five parts and topographical analysis was performed on each section.
  
  
  RESULTS
  Femora had single nutrient foramen in 47.7% of the cases, double foramen in 44.2% of the cases, triple in 3.5% of the cases and an absence of foramen in 4.6%. In the case of tibiae, 98.6% showed single foramen and in 1.4% of the cases, the foramen was absent. With respect to fibulae, 90.2% had single foramen and foramen was absent in 9.8%. The mean foraminal index was 38.9 for the femora, 32.5 for tibiae and 49.2 for fibulae. The majority (51.3%) of the foramina in the femora were located at the 2/5(th) part, 98.3% of the tibiae foramina at the 2/5(th) part and 60% of the fibulae at the 3/5(th) part.
  
  
  CONCLUSIONS
  The study provides information on the morphology and topography of nutrient foramina in lower limb long bones. The double foramina were more common in femur and rare in the tibia and fibula. The foramina of the femur and tibia were commonly observed at their upper part, whereas in the fibula they were present on the lower part. This knowledge of the nutrient foramina has to be kept in mind during surgical procedures.
authors: Departments of Anatomy Kasturba Medical College, Manipal University, Bejai, Mangalore,  India.
authors: Bv
authors: B
authors: Murlimanju
authors: Ku
authors: K
authors: Prashanth
authors: Latha V
authors: LV
authors: Prabhu
authors: Ganesh Kumar
authors: GK
authors: Chettiar
authors: Mangala M
authors: MM
authors: Pai
authors: Kvn
authors: K
authors: Dhananjaya
keywords: Foraminal index; long bones; morphology; nutrient foramen; topography
references: J Anat. 1979 Mar;128(Pt 2):315-22
references: 438092
references: Chin Med J (Engl). 1981 Jun;94(6):396-400
references: 6788483
references: Surg Radiol Anat. 1991;13(2):105-8
references: 1925909
references: World J Surg. 1998 Aug;22(8):845-51; discussion 852
references: 9673557
references: J Bone Joint Surg Br. 1953 Aug;35-B(3):462-6
references: 13084697
references: Acta Anat (Basel). 1952;15(3):261-80
references: 14952134
references: J Anat. 1977 Nov;124(Pt 2):299-304
references: 591428
references: Clin Orthop Relat Res. 1984 Apr;(184):141-4
references: 6705337
references: Langenbecks Arch Chir. 1997;382(3):123-7
references: 9324609
references: J Anat. 1967 Sep;101(Pt 4):813-22
references: 6059826
references: Int J Oral Maxillofac Implants. 1999 Nov-Dec;14(6):879-84
references: 10612927
references: Surg Radiol Anat. 1994;16(4):409-12
references: 7725197
references: Ann Anat. 2007;189(1):87-95
references: 17319614
references: J Anat. 1934 Jul;68(Pt 4):500-10
references: 17104499
references: Acta Anat (Basel). 1950;9(1-2):57-68
references: 15409814
references: J Anat. 1978 Mar;125(Pt 3):593-9
references: 640960
references: Surg Radiol Anat. 1987;9(3):251-5
references: 3122346