Neurovascular foramina of the human clavicle and their clinical significance

Purpose To study the topographic anatomy and morphology of neurovascular foramina of the human adult clavicles. Methods The study comprised 52 clavicles, which were obtained from the anatomy laboratory. The clavicles were macroscopically observed for the number, location and direction of the nutrient foramina. The foramen index was calculated for each clavicle by applying the Hughes formula. Results The neurovascular foramen was observed in 50 (96.1%) clavicles. The foramen was single in 20 (38.5%) clavicles, double in 23 cases (44.2%), and there were more than 2 foramina in 7 clavicles (13.4%). The foramen was present at the middle 1/3 region in 92.3% clavicles, at the medial 1/3 region in 9.6% and at the lateral 1/3 part in 1.9% clavicles. It was on the inferior surface in 55.8% clavicles, on the posterior surface in 69.2% and at the superior surface in only 1.9% of clavicles. The average distance of the foramen from the sternal end was 64.4 mm and the mean foraminal index was 44.72. Conclusions The present study observed that the foramina were more common on the posterior surface and were often multiple, directed toward the acromial end. Knowledge of the localization of nutrient foramina can be useful in certain surgical procedures to preserve circulation. We believe that the data obtained from the present study would be of interest to clinicians who are involved in procedures such as bone grafting, surgical approach for internal fixation and coracoclavicular ligament repair.