International Journal of Advanced and Integrated Medical Sciences

Show Contents

Study of Supratrochlear Foramen of Humerus: A Morphometric Study
  IJAIMS
ORIGINAL ARTICLE
Study of Supratrochlear Foramen of Humerus:A Morphometric Study
1Preeti Agarwal, 2SHH Zaidi
1Assistant Professor, 2Professor and Head
1Department of Anatomy, Varun Arjun Medical College &Rohilkhand Hospital, Bareilly, Uttar Pradesh, India
2Department of Anatomy, Rohilkhand Medical College &Hospital, Bareilly, Uttar Pradesh, India
Corresponding Author:
Preeti Agarwal, Assistant ProfessorDepartment of Anatomy, Varun Arjun Medical College &Rohilkhand Hospital, Bareilly, Uttar Pradesh, India,
e-mail:preetianat@gmail.com
10.5005/jp-journals-10050-10065
 
ABSTRACT
This study is conducted to know the incidence of supratrochlearforamen and its morphometry. A total of 38 humerus bonesare studied in the Indian population sample, in light of availableliterature, and clinical, racial, and regional significance isdrawn, if present.
Materials and methods: Thirty-eight humerus bones belongingto the museum of the Department of Anatomy, RohilkhandMedical College & Hospital, Bareilly, Uttar Pradesh, India, werestudied to observe the incidence of supratrochlear foramenanomaly in the Indian population sample.
Results: The supratrochlear foramen anomaly was observedin 7 out of 38 humeri studied, i.e., 18.4%.
Conclusion: The findings are of considerable clinical, racial,and regional significance, and are discussed.
Keywords: Bony septum, Coronoid fossa, Supratrochlearforamen.
How to cite this article: Agarwal P, Zaidi SHH. Study ofSupratrochlear Foramen of Humerus: A Morphometric Study.Int J Adv Integ Med Sci 2017;2(1):8-10.
Source of Support: Nil
Conflicts of Interest: None
 
 

INTRODUCTION

A thin plate of bone separates the coronoid fossa presenton the anterior aspect of the lower end of humerus andolecranon fossa present posteriorly. This bony septumcan be either opaque or translucent and, in some cases,may be perforated to form a foramen called supratrochlearaperture, septal aperture, intercondylar foramen, orepitrochlear foramen.1 It is most commonly referred toas supratrochlear foramen. Meckel first described it in1825.2-4 Until 7 years of age, this septum is present, after which it is occasionally absorbed to form supratrochlearforamen.5,6 Various studies have demonstrated that thedistal portion of medullary canal in humeri with supratrochlearforamen was much narrower and shorter atthe entry point of a retrograde nail than in humeri nothaving septal aperture. Hence, anatomical knowledge ofvariations, such as supratrochlear foramen is important inintramedullary fixation. The presence of supratrochlearforamen is also important for radiologists and orthopedicsfor proper interpretation of X-rays, since they areradiolucent and are easily mistaken for osteolytic andcystic lesions.

 
MATERIALS AND METHODS

total of 38 humeri bones (15 right, 23 left) of humandriedhumeri of unknown age and sex were obtainedfrom the Department of Anatomy, Rohilkhand MedicalCollege & Hospital, Bareilly, Uttar Pradesh, India, andwere examined to determine the presence of supratrochlearforamen in the Indian population.

Shape of each foramen was noted and classified. Thevertical and transverse diameters were measured byusing digital vernier caliper.

RESULTS

The supratrochlear foramen (Fig. 1) was seen in a total ofseven bones (18.4%); it was observed in 13.3% cases on rightside and 21.7% cases on left side (Table 1). Hence, it wasmore common on the left humeri than on the right ones.

Study of Supratrochlear Foramen of Humerus: A Morphometric Study
Fig. 1: Supratrochlear foramen in humerus

8 IJAIMS

Study of Supratrochlear Foramen of Humerus: A Morphometric Study

Table 1: Incidence of supratrochlear foramen of38 humerus
Study of Supratrochlear Foramen of Humerus: A Morphometric Study

Table 3: Mean vertical and transverse diameter ofsupratrochlear foramen
Study of Supratrochlear Foramen of Humerus: A Morphometric Study

Table 5: Racial incidence of septal aperture
Study of Supratrochlear Foramen of Humerus: A Morphometric Study

Septal aperture was found more in left humerus,which is in line with findings of other races (Tables 2 to 4).

DISCUSSION

Anthropologists claim it is important in establishingthe relationship between human and lower animals.7According to Hrdlicka, the supratrochlear foramen isvery frequent in primates other than man.8

A number of hypotheses were proposed regardingcause of supratrochlear foramen; some say it may be anatavistic character.9 Mechanical pressure caused duringhyperextension can be one of the causes.10 Large olecranonprocess was suggested by few.11 Some believe thatsupratrochlear foramen is formed by resorption from theanterior surface of septum.

It was suggested by Mays that hyperextension ofelbow joint results in perforation due to resorption ofhumeral septum, when coronoid processes of ulna makecontact with it. There is a huge variation in the rate ofsupratrochlear foramen occurrence in various humanpopulations. Racial incidence of septal aperture is shownin Table 5.

In the present study, the vertical diameter of supratrochlearforamen was 4.91 mm on the right side and3.75 mm on left side, and the transverse diameter was4.75 mm on the right side and 6.03 mm on left side(Table 6).

 
Table 2: Comparative data in (%) of supratrochlear foramen humerus
Study of Supratrochlear Foramen of Humerus: A Morphometric Study

Table 4: Different shapes of supratrochlear foramen
Study of Supratrochlear Foramen of Humerus: A Morphometric Study

Table 6: Comparative statistical data of supratrochlear foramenof humerus in various studies
Study of Supratrochlear Foramen of Humerus: A Morphometric Study
TD: Transverse diameter; VD: Vertical diameter

CLINICAL IMPORTANCE
  • It depicts evolutionary aspects of the foramen in additionto its surgical and orthopedic significance.
  • About 75% of all injuries in children are due to supratrochlearfracture.12
  • It is associated with narrow medullary canal; theknowledge of presence of supratrochlear foramenmay be important for pre-op planning for treatmentof supratrochlear fracture.
  • Awareness of the morphometry of the shapes mayhelp to avoid misinterpretation of radiology.13

CONCLUSION

The present study showed 18.4% supratrochlear foramenincidence in Indian population with left side predominance.We believe that this study will contribute tothe literature, anatomical knowledge of supratrochlearforamen, and is beneficial for anatomists, anthropologists,orthopedic surgeons, and radiologists.

REFERENCES
  1. Soni S, Verma M, Ghulyani T, Saxena A. Supratrochlearforamen: an incidental finding in the foothills of Himalayas.OA Case Reports 2013 Aug;2(8):75.

International Journal of Advanced & Integrated Medical Sciences, January-March, Vol 2, 20179

Preeti Agarwal, SHH Zaidi

  1. Diwan RK, Rani A, Chopra J, Srivastava AK, Sharma PK,Verma RK, Pankaj AK. Incidence of supratrochlear foramenof Humerus in North Indian population. Biomed Res2013;24(1):142-145.
  2. Blakely RL, Marmouze RJ, Wynne DD. The incidence of theperforation of the coronoid-olecran septum in the middleMississippian population of Dickson Mounds, Fulton County,Illinois. Proc Indiana Acad Sci 2013;78:73-82.
  3. Veerappan V, Ananthi S, Kannan NG, Prabhu K. Anatomicaland radiological study of supratrochlear foramen of humerus.World J Pharm Pharm Sci 2013;2(1):313-320.
  4. Hima BA, Narasinga RB. Supratrochlear foramen-a phylogenicremnant. Int J Basic Appl Med Sci 2013;3(2):130-132.
  5. Nayak SR, Das S, Krishnamurthy A, Prabhu LV, Potu BK.Supratrochlear foramen of the humerus: an anatomicoradiologicalstudy with clinical implications. Ups J Med Sci2009;114(2):90-94.
  6. Kate BR, Dubey PN. A note on the septal apertures in thehumerus of Central Indians. Eastern Anthropol 1970;33:105-110.

 
  1. Hirsh IS. The supratrochlear foramen: clinical andanthropological considerations. Am J Surg 1927 May;2(5):500-505.
  2. Tyllianakis M, Tsoumpos P, Anagnostou K, Konstantopoulou A,Panagopoulos A. Intramedullary nailing of humeraldiaphyseal fractures. Is distal locking really necessary? IntJ Shoulder Surg 2013 Apr;7(2):65-68.
  3. Jaswinder KZ. Supratrochlear foramen of humerus.A morphometric study. Indian J Basic Appl Med Res2013;7(2):651-654.
  4. Papaloucas C, Papaloucas M, Stergioulas A. Rare casesof humerus septal apertures in Greeks. Trends Med Res2011;6(3):178-183.
  5. Ananthi S, Manickam S, Vaithianathan G, Aruna S. Study ofintercondyloid foramen of humerus. Intercondyloid foramen.Rev Arg Anat Clin 2011;3(1):32-36.
  6. Ndou R, Smith P, Gemell R, Mohatla O. The supratrochlearforamen of the humerus in a South African dry bone sample.Clin Anat 2013 Oct;26(7):870-874.

10IJAIMS