Clavicular nutrient foramina in dry human bones: surface distribution, regional localisation, and surgical relevance.

IF 1.2 4区医学 Q2 Medicine

Surgical and Radiologic Anatomy Pub Date : 2026-07-08 DOI:10.1007/s00276-026-03943-6

Kashish Gupta, Rohini Punja, Arun Kumar Shetty, Purnima Adhikari, Sonal Nayak

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引用次数: 0

Abstract

Purpose: Iatrogenic disruption of the clavicular nutrient artery during fracture fixation has been implicated in non-union. Population-specific data on nutrient foramen location are lacking for Indian skeletal collections. This study characterises clavicular nutrient foramina in an institutional dry bone series and benchmarks the findings against published international data.

Methods: 121 unpaired dry adult human clavicles (60 right, 61 left) of unknown age and sex were examined. Foramen count, surface location (inferior/posterior/superior/anterior), total clavicular length (TL), distance of the foramen from the sternal end (DNF), and foraminal index (FI = DNF/TL × 100) were recorded. Segment classification (medial/middle/lateral third) was based on FI tertiles (0-33%, 33-66%, 66-100%), following the convention of Hughes [8], which allows comparison across bones of different total lengths. Categorical variables (foramen count, surface distribution) were compared between sides using Fisher's exact test; continuous variables (TL, DNF, FI) were compared using independent-samples t-tests (p < 0.05).

Results: 146 foramina were identified; 114 clavicles (94.2%) bore at least one foramen. Single foramina predominated (76.9%; 95% CI 68.6-83.5%); seven clavicles (5.8%) had none. Surface analysis revealed near-equal inferior (48.6%; 95% CI 40.7-56.7%) and posterior (49.3%; 95% CI 41.3-57.3%) distribution. Middle-third localisation was observed in 98.2% of foraminated clavicles (FI 33-66%). Mean TL was 138.5 ± 11.3 mm; mean DNF 72.1 ± 12.1 mm; mean FI 52.1 ± 7.9%. No significant bilateral asymmetry was detected in FI (p = 0.728) or DNF (p = 0.091).

Conclusion: This institutional dry bone series confirms middle-third predominance and identifies near-equal inferior and posterior surface distribution-a pattern also reported by a second independent South Indian study. These findings suggest that both inferior and posterior surfaces of the clavicular midshaft may warrant surgical awareness in this population. Direct clinical recommendations require validation through vascular or biomechanical studies.

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干骨中的锁骨营养孔：表面分布、局部定位和手术相关性。

目的：骨折固定过程中医源性锁骨营养动脉断裂与骨不愈合有关。印度人的骨骼标本缺乏营养孔位置的人口特异性数据。本研究在机构干骨系列中描述锁骨营养孔，并将研究结果与已发表的国际数据进行对比。方法：对年龄、性别不详、未配对的成人锁骨121根（右60根，左61根）进行检查。记录孔数、表面位置（下/后/上/前）、锁骨总长度（TL）、孔距胸骨末端的距离（DNF）和孔指数（FI = DNF/TL × 100）。节段分类（内/中/外侧三分之一）基于FI分值（0-33%,33-66%,66-100%），遵循Hughes[8]的惯例，允许在不同总长度的骨骼之间进行比较。采用Fisher精确检验比较两侧间的分类变量（孔数、表面分布）；使用独立样本t检验比较连续变量（TL， DNF， FI） (p)结果：鉴定出146个椎间孔；114个（94.2%）锁骨至少有一个椎间孔。单孔为主（76.9%;95% CI 68.6-83.5%）；7例（5.8%）无锁骨。表面分析显示近似相等的劣势分布（48.6%;95% CI 40.7-56.7%）和后验分布（49.3%;95% CI 41.3-57.3%）。98.2%的有孔锁骨定位中三分之一（FI 33-66%）。平均TL为138.5±11.3 mm；平均DNF 72.1±12.1 mm；平均FI 52.1±7.9%。FI （p = 0.728）和DNF （p = 0.091）未发现明显的双侧不对称。结论：该机构的干骨系列证实了中三分之一的优势，并确定了接近相等的下表面和后表面分布——另一项独立的南印度研究也报道了这种模式。这些发现表明，在这一人群中锁骨中轴的下表面和后表面都需要手术注意。直接临床推荐需要通过血管或生物力学研究验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.