Morphologic study of diaphyseal nutrient foramina in dried fibulae and its clinical implications

Jayaprakash T.


Background: Fibula is an important site for muscle attachment. It is used as a vascularised graft for conditions such as stabilization of lost mandible, spine and even the tibia. The knowledge of morphological and topographic distribution of nutrient foramina of fibula is important to avoid damage to the nutrient arteries during surgical procedures.

Methods: The study was conducted on 50 adult dried fibulae. Diaphyseal nutrient foramina were identified by their elevated margins and by the presence of a distinct groove proximal to them. Foramen index was calculated.

Results: 90% fibulae showed single nutrient foramen, in 8% of fibulae nutrient foramen was absent and 2% fibulae presented with double nutrient foramina. 95.74% nutrient foramina were directed away from growing end, while 4.54% nutrient foramina were directed towards the growing end. 82.7% nutrient foramina were observed in the middle zone. All the foramina were present on the posterior surface. 48.93% of the foramina were present on the medial crest, 38.29% were present between the medial crest and posterior border. The mean foramen index of all the fibulae studied was 43.73.   

Conclusions: The knowledge of nutrient foramina is essential to preserve the vascularity of bone. This study aids the clinician in fracture reductions and bone grafting. 


Fibula, Diaphyseal nutrient foramina, Foramen index, Bone graft

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