Anatomical Variations of Nutrient Foramina in Dry Adult Femur Bones among North Indian Population: A Cross-sectional Study

Introduction: The diaphysis of the femur is primarily supplied by the nutrient artery, which traverses the nutrient foramen. Typically, the femoral diaphysis presents with one or more nutrient foramina. Usually, two nutrient arteries originate from the first and third perforating branches of the profunda femoris artery. When only a single major nutrient artery is present, it originates from the second perforating branch. Generally, the nutrient foramen or foramina are located in the middle third of the femoral shaft, on or close to the linea aspera. Aim: To comprehensively analyse the nutrient foramina in the femur by determining their number, location, and direction. Materials and Methods: The present cross-sectional study was conducted on 50 dry adult femurs (25 right-sided and 25 left-sided) of unspecified sex, obtained from the bone bank of the Department of Anatomy, SGT University, Gurugram, Haryana, India. The number, location, and direction of the diaphyseal nutrient foramina were observed over a period of six months from May 2024 to October 2024 using visual inspection (subjective evaluation). All measurements were performed twice to minimise error, and the mean value was recorded. The data were analysed using Statistical Package for Social Sciences (SPSS) software (version 30). The mean, range, percentages, t-values, and p-values were calculated and presented in tabular form. Results: All nutrient foramina were directed proximally. The number of foramina ranged from zero (one bone) to four (one bone). The majority of bones (32 femurs) had double foramina. Single foramina (14 femurs) were generally located in the upper third of the shaft, while double foramina (32 femurs) were more commonly located in the middle third. In the present study, a single nutrient foramen (2%) was observed on the popliteal surface of the left femur, a finding not reported in earlier studies. Conclusion: Diaphyseal nutrient foramina show significant variation in number and location. The present study will be beneficial for orthopaedic surgeons in planning surgical procedures involving the femur, such as arthroplasty, bone grafting, and fracture reduction, where maintenance of adequate blood supply is essential for successful outcomes.