The nutrient artery of the humerus arises from the brachial artery or the profunda brachii and enters the humeral shaft through the nutrient foramen on the anteromedial surface, directed distally through the medullary canal to supply the cortical and medullary bone. It is the primary blood supply to the humeral diaphysis.
The nutrient artery is disrupted during humeral shaft nailing when the intramedullary canal is reamed, which partially compromises endosteal blood supply. Plate fixation of humeral shaft fractures preserves the nutrient artery if periosteal stripping is minimised. The nutrient foramen is a normal radiographic finding on AP humerus X-ray and must not be mistaken for a pathological lesion.
Compromised nutrient artery supply from extensive periosteal stripping or intramedullary reaming during fracture fixation, predisposing to delayed union and cortical devascularisation.
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