TOPOGRAPHIC ANATOMY AND MORPHOLOGY OF NUTRIENT FORAMEN OF THE CLAVICLE: AN OSTEOLOGICAL STUDY

Abstract

Pushpalatha M1, Sharmadha K. L2, Meenakshi P3

OBJECTIVE: To study the topographical and morphological aspects of nutrient foramen of the human clavicle

METHODS: 52 adult dry human clavicles irrespective of sex and age were studied macroscopically with help of magnifying glasses the data were collected on a standardized sheet and morphologically analyzed. The distance of the from sternal end was also determined

OBSERVATION: neurovascular foramina were observed in 50 (96.1%) clavicles and found absent in 2 clavicles (3.9%). The foramen was single in 20 (38.5%) clavicles, double in 23 cases (44.2%) and 7 clavicles (13.4%) had more than 2 foramina (Fig. 1D). In 48 clavicles (92.3%), the foramen was observed in the middle 1/3 region (Fig. 2A). In 5 clavicles (9.6%), the foramen was at the medial 1/3 region (Fig. 2B) and in one clavicle (1.9%), it was seen on the lateral 1/3 (Fig. 2C). The average distance of the foramen from the sternal end was 6.23cm. In 29 (55.8%) of the clavicles, the foramen was on the inferior surface (Fig. 1B). Whereas 36 (69.2%) clavicles, the foramen was observed on the posterior surface (Fig. 1A). Only one clavicle (1.9%) had the foramen at its superior surface (Fig. 1C)

CONCLUSION: In the present study we observed the neurovascular foramina in 96.1% of the clavicles. Most of the foramina (96%) were directed towards the acromial end which gives the idea that sternal end of clavicle is the growing end. The presence of nutrient foramen in the posterior surface in significant number of cases contradicts the classical presentation in its inferior surface. Knowledge of the localization of nutrient foramina can be useful in certain surgical procedures to preserve the circulation. Microvascular bone transfers’ being more popular now, this study helps to focus towards a better approach.

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