Anatomic determination of humeral head retroversion: The relationship of the central axis of the humeral head to the bicipital groove

Tillett, Edward D.; Smith, Mark M.; Fulcher, S Marcus; Shanklin, Joel

doi:10.1016/s1058-2746(09)80085-2

Cited by 43 publications

(21 citation statements)

References 3 publications

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“…Adding this angle to the mean retroversion of 20°found in this study with respect to the transepicondylar axis achieves a close approximation of the 30°to 40°in the surgical literature. However, previous authors report some variation is present between individuals for both values of humeral head posterior offset [4,48,54] and carrying angle [36,47,53,55,56]. Therefore, accounting for these differences by increasing retroversion may result in correct positioning in some patients, but large errors in others.…”

Section: Discussionmentioning

confidence: 98%

“…Two geometric considerations can assist in explaining this difference. First, previous interpretations of retroversion have not taken into account the posterior displacement of the humeral head articular surface, which is between 2 mm and 7 mm [4,48,54]. It is probable that a larger retroversion has been recommended to avoid increased anterior offset of the prosthetic humeral head [4,14,20].…”

Section: Discussionmentioning

confidence: 99%

“…The CT scan method and the computer-assisted method enabled measurement of the distance between the central axis of the humeral head (defined as the center of rotation of the humeral head articular surface) and the posterior margin of the bicipital groove as performed by Tillet et al [54]. This was performed on 20 humeri (ie, 10 pairs) to allow comparison of contralateral differences.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

CT Scan Method Accurately Assesses Humeral Head Retroversion

Boileau

Bicknell

Mazzoleni

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Humeral head retroversion is not well described with the literature controversial regarding accuracy of measurement methods and ranges of normal values. We therefore determined normal humeral head retroversion and assessed the measurement methods. We measured retroversion in 65 cadaveric humeri, including 52 paired specimens, using four methods: radiographic, computed tomography (CT) scan, computer-assisted, and direct methods. We also assessed the distance between the humeral head central axis and the bicipital groove. CT scan methods accurately measure humeral head retroversion, while radiographic methods do not. The retroversion with respect to the transepicondylar axis was 17.9 degrees and 21.5 degrees with respect to the trochlear tangent axis. The difference between the right and left humeri was 8.9 degrees. The distance between the central axis of the humeral head and the bicipital groove was 7.0 mm and was consistent between right and left humeri. Humeral head retroversion may be most accurately obtained using the patient's own anatomic landmarks or, if not, identifiable retroversion as measured by those landmarks on contralateral side or the bicipital groove.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

CT Scan Method Accurately Assesses Humeral Head Retroversion

Boileau

Bicknell

Mazzoleni

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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show abstract

“…However, it has been documented that the bicipital groove shifts medially from proximal to distal, giving different values depending on the level of the fracture. 2,5,7,8,10,12,13,15,18 The purpose of this study was to determine the value of the upper edge of the pectoralis major insertion as a landmark for establishing proper height and version of hemiarthroplasties implanted for proximal humeral fractures. …”

mentioning

confidence: 99%

The pectoralis major tendon as a reference for restoring humeral length and retroversion with hemiarthroplasty for fracture

Torrens

Corrales

Melendo

et al. 2008

Journal of Shoulder and Elbow Surgery

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“…In 1993 Tillet et al [18], after making studies on a cadaver, suggested the identification of biceps sulcus as a landmark in humeral prosthetic reconstruction. His suggestion was to put the prosthesis lateral fin 9 mm behind the sulcus back edge, in order to find the proper retroversion.…”

Section: Discussionmentioning

confidence: 99%

Medial reconstruction technique in the treatment of complex fractures of humeral proximal epiphysis with SMR prosthetic modular system

et al. 2008

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Prosthetic treatment of complex fractures of humeral proximal meta-epiphysis is a very complex surgery that often does not lead to satisfactory results. Indeed, although in the last 35 years since Neer's studies some progress has been made in the knowledge of the anatomy of humeral meta-epiphysis proximal portion, surgical technique and prosthetic design, in the literature we find non-homogeneous experiences regarding the clinical-functional results. At the same time, such experiences agree as far as pain relief is concerned. We report our experience in the treatment of complex fractures of humeral proximal epiphysis with SMR (Lima Lto, San Daniele, Italy) prosthetic system, using our surgical technique of anatomical reconstruction, starting from the medial neck. The case histories, 35 patients, 30 women and 5 men, aged between 56 and 79, were reported in the observation period between April 2000 and February 2005. In 20 cases the right shoulder was treated and in 15 the left one. At the follow-up the patients were assessed clinically by the average Constant Score and also by X-rays and CT scan in order to measure the prosthesis height, its off-set and retroversion.

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Anatomic determination of humeral head retroversion: The relationship of the central axis of the humeral head to the bicipital groove

Cited by 43 publications

References 3 publications

CT Scan Method Accurately Assesses Humeral Head Retroversion

CT Scan Method Accurately Assesses Humeral Head Retroversion

The pectoralis major tendon as a reference for restoring humeral length and retroversion with hemiarthroplasty for fracture

Medial reconstruction technique in the treatment of complex fractures of humeral proximal epiphysis with SMR prosthetic modular system

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