Research on Supra-trochlear foramen and its clinical significance

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Research on Supra-trochlear foramen and its clinical significance

Supra-trochlear foramen is not described in textbooks of anatomy and orthopedicsbut clinically and radiologically its presence in adult human humerus is very important for intramedullary nailing for treatment of supracondylar fractures and to prevent misinterpretation of radiographs respectively. The study was carried on 222 dry adult human humeri (113 right sided and 109 left sided), of unknown sex, for the presence of supra-trochlear foramen. When foramen was present then its shape was observed and remaining bones were observed for translucency and perforation ofcoronoid-olecranon septum. Results:Supra-trochlear foramen was present in 77 (34.68%) humeri. It was present on right side in 39 (34.51 %) bones out of 113 and on left side in 38(34.86 %) bones out of 109. We observed translucency of the coronoid-olecranon septum in 105 bones and it was perforated in 15 bones. We observed three different types of shape of supra-trochlear foramen. The results of our study showed that the incidence of supra-trochlear foramen was almost same on right and left side. Its high incidence in Indian population requires special attention during surgery especially intramedullary humeral nailing of humerusand interpretation of X-rays by radiologists.

A thin plate of bone which separates the coronoid fossa in front and the olecranon fossa behind of humerus is known as the coronoid-olecranon septum (COS). This septum is lined in fresh state by the synovial membrane of elbow joint and its thickness varies from 0.5mm to 1cm. Sometimes, this thin bony plate becomes transparent or may contain several perforationsor in some humeri it may become perforated to form a foramenwhich is known as supra-trochlear foramen (STF) or septal aperture.

Supra-trochlear foramen is not described in textbooks of anatomy and orthopedics. However, its high incidence in Indian population requires special attention during surgery especially intramedullary humeral nailing of humerusand interpretation of X-rays by radiologists. This data will be helpful for orthopedic surgeons, radiologist and anatomist. Also, erroneous study should be done in different ethnic groups as well as individuals of the same ethnic groups with similar habits and occupation with the help of dry bones, cadaveric study and new imaging techniques which will provide us detail knowledge.

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