Scholarlink

Purpose <p>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.</p> Methods <p>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 [<CitationRef CitationID="CR8">8</CitationRef>], 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 (<i>p</i> &lt; 0.05).</p> Results <p>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&#xa0;mm; mean DNF 72.1 ± 12.1&#xa0;mm; mean FI 52.1 ± 7.9%. No significant bilateral asymmetry was detected in FI (<i>p</i> = 0.728) or DNF (<i>p</i> = 0.091).</p> Conclusion <p>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.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

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

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月8日

查看全文
  • Kashish Gupta,
  • Rohini Punja,
  • Arun Kumar Shetty,
  • Purnima Adhikari,
  • Sonal Nayak

摘要

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.