• Ejaz Afzal Nowshera Medical College
  • Fatima Sherin Ayub Medical College
  • Omair Khan Ayub Medical College
  • Noaman Hussain Siddiqui Ayub Medical College


Background: osteogenesis needs circulation of blood in the bones. Bone growth, repair of fracture, maintenance of bone vitality and other injures also need blood circulation in proper way. Blood is allowed to flow via holes in the diaphysis, which are called as nutrient foramina. Methods: The cross-sectional study was done in the department of Anatomy, Ayub and Khyber Medical College (Osteology Sections). The aim was to observe diaphyseal nutrient foramina in the human long bones of the lower limb. The study was done on 90 long bones of lower limb consisting of 30 femora, 30 tibiae and 30 fibulae. Of all these bones, sex was not determined. All the bones were macroscopically observed. For the number of the foramina, simple counting was done. The foraminae 1 mm away from the borders were counted. All positions were seen macroscopically. For direction and obliquity, stiff wire was used. Results: We studied 90 long bones of lower limb. About 80% of long bones of lower limb showed single nutrient foramina. About 18% of lower limb long bones showed two nutrient foraminae. In cases of femora nutrient foraminae were directed proximally. In cases of fibulae and tibiae most of the foramina were directed distally. Conclusion: the study has provided additional information on the foramina index, morphology and topography of the nutrient foramina. In the lower limb long bones, the anatomical data is important for the clinicians as the micro-vascular bone transfer is becoming popular. This morphological data can be used by the forensic experts in identification through different landmarks in bones development giving an aid in medicolegal work.  Keywords: Micro-vascular bone transfer; topography; femora; tibiae; proximally; distally; osteology; diaphysis 

Author Biographies

Ejaz Afzal, Nowshera Medical College

Department of Anatomy, Nowshera Medical College, Nowshera

Fatima Sherin, Ayub Medical College

Assosiate Prosessor, Anatomy Department

Omair Khan, Ayub Medical College

Assoisstant Professor, Department of Forensic Medicine

Noaman Hussain Siddiqui, Ayub Medical College

Department of Pathology


Al-Motabagani. The arterial architecture of the human femoral diaphysis. J Anat Soc India 2002;51(1):27–31.

Anderson HC. Matrix vesicles and calcification. Curr Rheumatol Rep 2003;5(3):222–6.

Beier F. Cell Cycle control and the cartilage growth plate. J Cell Physiol 2005;202(1):1–8.

Collipal E, Vargas R, Parra X, Silva H, Del Sol M. Diaphyseal nutrient foramina in the femur, tibia and fibula bones/Foramenes nutricios diafisarios de los huesos femur, tibia y fibula. Int J Morphol 2007;25(2):305–9.

Craig JG, Widman D, van Holsbeeck M. Longitudinal stress fracture: patterns of edema and the importance of the nutrient foramen. Skeletal Radiol 2003;32(1):22–7.

Kizilkanata E, Boyana N, Ozsahina ET, Soamesb R, Oguza O. Location, number and clinical significance of nutrient foramina in human long bones. Ann Anat 2007;189(1):87–95.

Giustina A, Mazziotti G, Canalis E. Growth hormone insulin like growth factors and the skeleton. Endocr Rev 2008;29(5):535–95.

Gotzen N, Cross AR, Ifju PG, Rapoff AJ. Understanding stress concentration about a nutrient foramen. J Biomech 2003;36(10):1511–21.

Grabowski P. Physiology of bone. In: Calcium and Bone Disorders in Children and Adolescents. Karger Publishers; 2009. p.32–48.

Gualdi-Russo E, Galletti L. Human activity patterns and skeletal metric indicators in the upper Limb. Coll Antropol 2004;28(1):131–43.

Gumusburun E, Yucel F, Ozkan Y, Akgun Z. A study of the nutrient foramina of lower limb long bones. Surg Radiol Anat 1994;16(4):409–12.

Hattori T, Muller C, Gebnard S, Bauer E, Pausch F, Schlund B, et al. SOX9 is a major negative regulator of cartilage vascularization, bone marrow formation and endochondral ossification. Development 2010;137(6):901–11.

Fernández-Tresguerres-Hernández-Gil I, Alobera-Gracia MA, del-Canto-Pingarrón M, Blanco-Jerez L. Physiological basis of bone regeneration II. The remodeling process. Med Oral Patol Oral Cir Bucal 2006;11(2):151–7.

Kobayashi S, Takashi HE, Ito A, Saito N, Nawata M, Horiuchi H, et al. Trabecular minimodeling in human iliac bone. Bone 2003;32(2):163–9.

Lacroix P. The organization of bones. Landon: J. & A. Churchill LTD.; 1951.

Lindsay R, Cosmen F, Zhou H, Bostrom MP, Shen VW, Cruz JD, et al. A novel tetracycline labelling schedule for longitudinal evaluation of the short-term effects of anabolic therapy with a single iliac crest biopsy: Early actions of teriparatide. J. Bone Miner Res 2006;21(3):366–73.

Lutken, P. Investigation into the position of the nutrient foramina and the direction of the vessel canals in the shafts of the humerus and femur in man. Cell Tissues Organs 1950;9(1-2):57–68.

Patake SM, Mysorekar VR. Diaphyseal nutrient foramina in human metacarpals and metatarsals. J Anat 1977;124(Pt 2):299–304.

Schiessel A. Zweymuller K. The nutrient artery canal of the femur: a radiological study in patients with primary total hip replacement. Skeletal Radial 2004;33(3):142–9.

Xing L, Boyce BF. Regulation of apoptosis in osteoclasts and osteoblastic cells. Biochems Biophys Res Commun 2005;328(3):709–20.



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