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Morphometric analyses of clavicle’s nutrient foramen



Fractures of the clavicle, which has an important location and function in the upper extremity and shoulder joint, compose 10% of all fracture cases. During the osteosynthesis of clavicle fractures and in the post-operative period of patients, considering the detailed morphometric and topographic properties of the nutrient foramen of clavicle is important to avoid the disruption of arterial nutrition of the clavicle and prevent unexpected injuries. The aim of this study was to investigate the morphometric properties of the nutrient foramen of clavicle in more detail using computedtomography images.


Computed tomography images of 116 healthy individuals (56 women/60 men) who had no pathology history were included in the presented study. Computed tomography images were reconstructed three-dimensionally using free-licensed Horos v3.3.3 software. Then, distances from clavicle’s nutrient foramen to sternal end, anterior and posterior edges of the clavicle were measured. Statistical analyses were completed using SPSS v21 software.


Our results demonstrated that the nutrient foramen of clavicle was located closer to the sternal end of the clavicle. The shortest distance to the sternal edge of clavicle was measured as 3.3 cm. Analyses of gender differences indicated that statistically significant differences were in favor of men. However, topographic properties of the clavicle’s nutrient foramen were not affected by age.


Nutrient foramen is mostly located closer to the sternal end of clavicle. Especially during osteosynthesis of clavicle fractures at the sternal end, maintaining the arterial supply of clavicle is of great importance for increasing the post-operative life quality of patients.

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Fig. 1


  1. 1.

    Crock HV (1996) Atlas of vascular anatomy of the skeleton and spinal cord. Martin Dunitz, London

  2. 2.

    Fischer LP, Carret JP (1978) Arterial vascularization of human bones. Bull Assoc Anat (Nancy) 62:419–452

  3. 3.

    Gouron R, Deroussen F, Juvet M, Ursu C, Plancq MC, Collet LM (2011) Early resection of congenital pseudarthrosis of the tibia and successful reconstruction using the Masquelet technique. J Bone Jt Surg Br 93b:552–554

  4. 4.

    Havet E, Duparc F, Tobenas-Dujardin AC, Muller JM, Delas B, Freger P (2008) Vascular anatomical basis of clavicular non-union. Surg Radiol Anat 30:23–28.

  5. 5.

    Kizilkanat E, Boyan N, Ozsahin ET, Soames R, Oguz O (2007) Location, number and clinical significance of nutrient foramina in human long bones. Ann Anat 189:87–95.

  6. 6.

    Knudsen FW, Andersen M, Krag C (1989) The arterial supply of the clavicle. Surg Radiol Anat 11:211–214

  7. 7.

    Kumar R, Madewell JE, Swischuk LE, Lindell MM, David R (1989) The clavicle: normal and abnormal. Radiographics 9:677–706.

  8. 8.

    Leschinger T, Krane F, Hackl M, van Tongel A, Scaal M, Muller LP, Wegmann K (2019) The dominant nutrient foramen at the clavicular midshaft: an anatomical study. Surg Radiol Anat 41:361–364

  9. 9.

    Murlimanju BV, Prabhu LV, Pai MM, Yadav A, Dhananjaya KV, Prashanth KU (2011) Neurovascular foramina of the human clavicle and their clinical significance. Surg Radiol Anat 33:679–682.

  10. 10.

    Murlimanju BV, Prashanth KU, Prabhu LV, Saralaya VV, Pai MM, Rai R (2011) Morphological and topographical anatomy of nutrient foramina in human upper limb long bones and their surgical importance. Rom J Morphol Embryo 52:859–862

  11. 11.

    Standring S (2016) Gray's anatomy : the anatomical basis of clinical practice. 41, Elsevier Limited, New York

  12. 12.

    Stillwell A, Ioannou C, Daniele L, Tan SL (2017) Osteosynthesis for clavicle fractures: How close are we to penetration of neurovascular structures? Injury 48:460–463.

  13. 13.

    Sukur E, Ozturkmen Y, Akman YE, Gungor M (2016) Clinical and radiological results on the fixation of Neer type 2 distal clavicle fractures with a hook plate. Acta Orthop Traumatol Turc 50:489–493.

  14. 14.

    Vatansever A, Demiryurek D, Ercakmak B, Ozsoy H, Hazirolan T, Senturk YE (2019) Redefining the morphometry of subclavian vessels for clavicle fracture treatments. Surg Radiol Anat 41:365–372.

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We would like to thank all members of Radiology Department of Medical Faculty of Hacettepe University for their great support.

Author information

DD Designing the study protocol, data analysis, manuscript writing, and editing. AV Designing the study protocol, data collection, data analysis, manuscript writing, and editing.

Correspondence to Alper Vatansever.

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Vatansever, A., Demiryürek, D. Morphometric analyses of clavicle’s nutrient foramen. Surg Radiol Anat (2020).

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  • Nutrient foramen
  • Clavicle
  • Non-union
  • Computed tomography
  • Anatomy