Anatomical variation in position, location and number of fibular nutrient foramen

Abstract

Background: Fibula is a slim bone. Its shape varies with the strength of the muscles attached. The fibula though transmits insignificant force in walking, fibula is an important bone for muscle attachment and significant source of bone graft. It has a proximal head narrow neck, long shaft and a distal lateral malleolus. The knowledge and position of the nutrient foramina of fibula is important to proceed with the free implant of the vascularized bone graft In harvesting the fibula, this segment is always taken, as the graft is more reliable regarding anastomosis, which includes endosteal and peripheral vascularization and associated with less post operative morbidity. Material and methods: 240 adult fibula of unknown sex. from: Govt. Medical college-Bhavnagar, K.J.Mehta Dental College, Amargadh Bhavnagar, Smt. N.H.L. Municipal Medical college Ahmadabad, B.J.Medical college, Ahmadabad, Gujarat were studied Above mentioned. Measurements were taken with Vernier Caliper. Results: Number: Out of 240 fibulae examined, 192(80%) showed a single foramen while 48(20%) possessed double foramina. Position: The nutrient foramina of fibulae were situated in the middle third of the bone with a foramen index ranging between 35.23% and 67.69% of the bone length of the total 288 foramina, 280(97.2%) existed in the middle third and8 (2.7%) were in the distal third There were no foramina in the proximal third of the whole fibular foramina, 192 (66.6%) were on the medial crest of the posterior surface, 88(30.5%) on the posterior surface between medial crest and interosseous border and 8 (2.7%) on lateral surface Size: Of all fibular foramina, 32(11.1%) were dominant foramina while 256(88.8%) were secondary. Direction: Of the total 288 nutrient foramina observed in the fibulae, 224 (77.71%) was directed distally; while the direction of 64(22.2%) was proximally Obliquity: There was no change in the obliquity of the foramina, whether they were in the centre of bone or nearer to the ends. Conclusion: Fibula of 35.23 cm – 67.69 cm is available for grafting among Indians. The metric estimation of the position of the nutrient foramen of the fibula could assist in harvesting vascularised graft of the bone.