title: An Anatomical Study of the Nutrient Foramina of the Human Humeral Diaphysis.
abstract: BACKGROUND Understanding the nutrient foramina is critical to clinical practice. An insult to the nutrient foramina can be caused by trauma and/or surgical dissection and lead to devascularization and bad outcomes. Few studies have looked at the humerus, and no studies have described relative information of humeral nutrient foramen related to anatomical structures that might be located by palpable landmarks. In this study, we analyzed the anatomical features of the nutrient foramina of the diaphyseal humerus and provide a discussion of clinical relevance. MATERIAL AND METHODS We dissected 19 cadavers and analyzed the relative positions of the foramina and surrounding muscles, and the number, direction, diameter, and location of the nutrient foramina. Foramina index and a new landmark index were used to calculate the location. We compared the data from both sides and the relationships between transverse and longitudinal locations, diameter and total length, and foramina index and landmark index were also analyzed. RESULTS The humeri had one or two main nutrient foramina located in a small area between the coracobrachialis and brachial muscles and oriented toward the elbow. The mean diameter was 1.11±0.32 mm. The mean index and landmark index were 43.76±4.94% and 42.26±5.35%, respectively. There were no differences between sides in terms of diameter, length, or nutrient foramina index. There were no significant correlations between transverse and longitudinal locations or diameter and total length. The foramina index and landmark index showed strong positive correlation (r=0.994, p<0.0001). CONCLUSIONS Our study provides details about the nutrient foramina that will benefit clinicians who treat injuries and diseases of the humerus. Surgeons should be mindful of soft tissue in the foraminal area during surgical procedures.
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China (mainland).
authors.forename: Zichao
authors.initials: Z
authors.lastname: Xue
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China (mainland).
authors.forename: Haoliang
authors.initials: H
authors.lastname: Ding
authors.affiliation: Department of Orthopaedics, Shanghai Ruijin Hospital, Shanghai, China (mainland).
authors.forename: Chuanzhen
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China (mainland).
authors.forename: Haitao
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China (mainland).
authors.forename: Zhiquan
authors.initials: Z
authors.lastname: An
mesh_terms: D000328:Adult; D001158:Arteries / Q000502:physiology; D002102:Cadaver; D018483:Diaphyses / Q000033:anatomy & histology / Q000502:physiology; D005260:Female; D006253:Haversian System / Q000033:anatomy & histology* / Q000502:physiology; D006801:Humans; D006811:Humerus / Q000033:anatomy & histology* / Q000502:physiology; D008297:Male