Study of Neurovascular Foramina of the Human Clavicle and Their Clinical Significance.

Abstract

Background

The clavicle transfers the body weight from upper limb to the axial skeleton. Commonly one nutrient foramen is found on shaft of the clavicle away from the growing end and allows the passage of main nutrient artery. Vascularized clavicle helps principally in joint allograft and bone grafting. The objective of our study was to determine the number, position, direction, of nutrient foramen and the foraminal index.

Material & methods:

This present study was performed on 62 clavicles obtained from the Department of Anatomy and Forensic Medicine, IMS and SUM Hospital, Bhubaneswar. Among them 34 and 28 belongs to the right and left side respectively. The number, location and direction of nutrient foramina was documented and compared with the investigations done by the preceding authors. Mean foramen index was calculated by applying Hughes formula.

Result:

Total 92 nutrient foramina were observed in 62 bones. Out of them single foramina was detected in 42 (67.74%) and double foramina in 12 (19.35%). More than 2 nutrient foramina were found in 8 (12.89%) clavicles. Location of the foramina was more common on posterior surface (76%) than on the inferior surface (24%).  65.21% of the foramina were present in middle 1/3rd of the clavicle. All are directed away from the growing end of the bones. Our study shows the average distance of the foramen from the sternal end was 67.9mm and the mean foramen index was 53.80.

Conclusion:

Recognition of nutrient foramina is critical for vascularized bone graft, positioning of internal fixation, and in microsurgical vascularized bone transplantation. It also sustains arterial supply during the radiation therapy.