Morphometric, morphologic and topographic evaluation of diaphyseal nutrient foramina of the femur


PASLI B., Ulkir M., GÜNENÇ BEŞER C.

SURGICAL AND RADIOLOGIC ANATOMY, no.1, 2025 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2025
  • Doi Number: 10.1007/s00276-025-03611-1
  • Journal Name: SURGICAL AND RADIOLOGIC ANATOMY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, MEDLINE
  • Hacettepe University Affiliated: Yes

Abstract

Purpose Vascularization of bones is crucial for bone growth and repair. The nutrient artery, passing through the nutrient foramen, is key to bone blood supply, but its impact on fracture healing and complications is not fully understood. The study aims to investigate the morphology and location of the nutrient foramen in the femoral diaphysis and to understand its clinical implications for fractures. Methods In this study, 88 adult dry femurs of unknown age and sex were examined. The characteristics of the nutrient foramina, including number, size, direction, and localization were evaluated. The foraminal index [(distance from foramen to proximal end of femur/total length of femur) x 100], was employed to categorize the regions [Region-I, 0-33.33; Region-II, 33.34-66.66; Region-III 66.67-100]. Results The majority of the femurs had one or two foramina (92.94%). Of the total number of nutrient foramina, 121 (97.58%) were directed towards the proximal end, while three (2.42%) were horizontal. The majority of foramina were detected in sizes 18G (34.67%) and 20G (27.42%). All nutrient foramina were found on the posterior surface of the femur and adjacent to linea aspera. Sixteen nutrient foramina were located (12.90%) in Region-I, 104 (83.87%) in Region-II, and 4 (3.23%) in Region-III. Conclusions The nutrient foramina were typically located in the middle third of femur, adjacent to linea aspera on the posterior surface of femur. This observation indicates that the anterior surface is safer for surgery, while caution is needed near the linea aspera on the posterior surface.