Anatomical study of nutrient foramina in South Indian human femora: A cross-sectional observation with surgical relevance

The nutrient foramen serves as the entry point for the nutrient artery, crucial for bone growth, healing, and vascular supply. Its position varies during development and may influence surgical outcomes if damaged. Although global data exist, anatomical variations influenced by genetic and biomechanical factors in the South Indian population remain underexplored. This study examines the number, position, and orientation of nutrient foramina in South Indian femora and their surgical relevance. This cross-sectional study was conducted on 104 dry adult human femora at GSL Medical College, Andhra Pradesh. Each femur was assessed for the number, location, and surface position of nutrient foramina. The foraminal index was calculated using standard measurements. Orientation was evaluated and all measurements were repeated to ensure intra-observer reliability. Out of 104 femora, 63.46% had a single nutrient foramen, 35.58% had double, and 0.96% had triple foramina. Most foramina (74.83%) were located in the middle third of the femur, primarily on the linea aspera (71.33%). All foramina were oriented proximally. No statistically significant differences were found between sides in terms of foramina number, position, or femoral length. This study highlights the middle-third predominance and linea aspera localization of nutrient foramina in South Indian femora. The absence of significant correlation with the foraminal index underscores anatomical variability influenced by genetic and biomechanical factors, supporting the need for personalized surgical planning and region-specific anatomical references in orthopedic practice.