The Distance Between the Pectoral Major Tendon Insertion and the Top of the Humeral Head as a Landmark for Proper Placement of Hemiarthroplasty in Fractures of the Proximal Humerus

Murachovsky, Joel; Ikemoto, Roberto Yukio; Nascimento, Luis Gustavo Prata; Bueno, Rogério Serpone; Strose, Eric; Almeida, Luis Henrique

doi:10.1097/bte.0b013e3181695d9c

Cited by 5 publications

(9 citation statements)

References 22 publications

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“…In clinical practice there are some obstacles, repeated X-ray exposure before operation, and complicated pre-operation design. Joel et al introduced the distance at 5.5 cm between the pectoral major tendon insertion and the top of the humeral head as a landmark for proper placement of hemiarthroplasty in fractures of the proximal humerus (24). And the method is proved to be a useful and reliable reference for optimal humeral height during hemiarthroplasty for proximal humerus fractures in Asian populations (12).…”

Section: Discussionmentioning

confidence: 99%

A New Method to Determine the Humerus Height and Humeral Head Retroversion for Hemiarthroplasty

Wei

et al. 2020

Preprint

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Background Placement of shoulder prosthesis used for reconstruction of a complex proximal humerus fractures is critical because it is related to clinical outcomes after hemiarthroplasty. To achieve the anatomical placement of the prosthesis, we introduced a simple operative method to determine the humerus height and humeral head retroversion, and retrospectively investigated the clinical and radiographic outcomes of our procedure.Method 34 patients, treated by shoulder arthroplasty for 4-part or 3–part proximal humeral fracture during the period between June 2016 and December 2018, were enrolled in the study. Eventually 29 patients, 18 women and 11 men with an average age of 68.4 years (range 58–85 years), were followed up successfully. Of which 13 patients treated with classic method were matched to 19 of the 29 new method treated patients by operation time, blood loss, pain, range of motion, Constant-Murley score and radiographic features.Results There was a significant difference between the two treatment groups in operation time (p = 0.024), while there was no significant difference in blood loss (p = 0.078). No significant difference was found between the two treatment groups in Visual Analog scale (p = 0.225), Constant-Murley score (p = 0.930), and radiological outcomes (p = 0.504). There was linear regression and correlation between Constant-Murley score and age (p = 0.027), while there was no linear relationship between status of tuberosity and the function of the shoulder joint (p = 0.931).Conclusion We introduce a new operative technique to determine the humerus height and humeral head retroversion for shoulder arthroplasty operation. Based on the data, there is linear regression and correlation between Constant-Murley score and age, while there is no linear relationship between status of tuberosity and the function of the shoulder joint. Our present analyses reveal that our protocol is personalized, easy, effective and feasible.

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Section: Discussionmentioning

confidence: 99%

A New Method to Determine the Humerus Height and Humeral Head Retroversion for Hemiarthroplasty

Wei

et al. 2020

Preprint

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“…In clinical practice there are some obstacles, repeated X-ray exposure before operation, and complicated pre-operation design. Joel et al introduced the distance at 5.5 cm between the pectoral major tendon insertion and top of the humeral head as a landmark for proper placement of hemiarthroplasty in fractures of the proximal humerus (21). And the method is proved to be a useful and reliable reference for optimal humeral height during hemiarthroplasty for proximal humerus fractures in Asian populations (9).…”

Section: Discussionmentioning

confidence: 99%

Anatomic placement of shoulder prosthesis for complex proximal humerus fractures: A modified method for hemiarthroplasty

Wei¹,

Li²,

Bu³

et al. 2020

Preprint

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BackgroundThe placement of shoulder prosthesis used for reconstruction of a complex proximal humerus fractures is challenging. To achieve the anatomical placement of prosthesis, we introduced a new operative technique to determine the humerus height and humeral head retroversion. Herein, we retrospectively investigated the clinical and radiographic outcomes of our procedure.Method34 patients, treated by shoulder arthroplasty for 4-part or 3–part proximal humeral fracture during the period between June 2016 and December 2018, were enrolled in the study. Eventually 29 patients, 18 women and 11 men with an average age of 68.4 years (range 58–85 years), were followed up successfully. Of which 13 patients treated with classic method were matched to 19 of the 29 new method treated patients by operation time, blood loss, pain, range of motion, Constant-Murley score and radiologic features.ResultsThere was significant difference between the two treatment groups in operation time (p = 0.024), while there was no significant difference in blood loss (p = 0.078). No significant difference was found between the two treatment groups in Visual Analog scale (p = 0.225), Constant-Murley score (p = 0.930), and radiological outcomes (p = 0.504). There was linear regression and correlation between Constant-Murley score and age (p = 0.027), while there was no linear relationship between status of tuberosity and the function of the shoulder joint (p = 0.931).ConclusionWe introduce a new operative technique to determine the humerus height and humeral head retroversion for shoulder arthroplasty operation. Based on the data, there is linear regression and correlation between Constant-Murley score and age, while there is no linear relationship between status of tuberosity and the function of the shoulder joint. Our present analyses reveal that our protocol is personalized, easy, effective and feasible.Trial registration: https://doi.org/10.1186/ISRCTN28175069.

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“…11 12 18 Murachovsky et al had first defined this distance as 56 mm which was independent of the height of the person. 11 Torrens et al also defined this distance as 56 mm with a variation of 1 cm. 12 However, Figueiredo et al showed this distance to be 59 mm.…”

Section: Discussionmentioning

confidence: 99%

“…9 10 Murachovsky et al had suggested a distance of 5.6 cm from the superior edge of pectoralis major tendon as a landmark to decide upon the height of the humeral head prosthesis. 11 Many surgeons use this landmark intraoperatively to decide on the adequate height of the humeral prosthesis. 12 Our purpose was to study the superior insertion of the pectoralis major tendon and analyze whether this can be used as a consistent landmark to judge the height of the humeral head which can be later used to decide the height of the humeral head prosthesis.…”

Section: Introductionmentioning

confidence: 99%

The Distance between the Pectoralis Major Tendon Insertion and the Top of the Humeral Head is a Reliable Landmark: An Anatomic Study

Sahu

Jagiasi

Valavi

et al. 2019

Joints

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Purpose This study aimed to analyze the distance between the superior edge of the pectoralis major and the top of the humeral head and evaluate whether this distance is a consistent measurement. Methods Twenty-two shoulders in eleven cadavers were dissected and the attachment of the pectoralis major tendon was preserved. Two distances were recorded with the help of digital vernier caliper: the distance between the upper edge of pectoralis major and tangent to the top of humeral head (PM–T) and the distance between the superomedial tip of greater tuberosity (GT) and the upper edge of the pectoralis major tendon (PM–G; ± standard error of the means). Results The mean PM–T distance was 53.8 mm (±0.8 mm) and the mean PM–G distance was 46.8 mm (±0.9 mm). The distance between the top of humeral head and tip of the GT was 7 mm. The PM–T distance was a significant outlier in three shoulders as it inserted high on the humerus. Conclusion We can conclude that the PM–T and PM–G distances were a consistent measurement. Clinical Relevance The distance between the pectoralis major tendon and top of the humeral head was measured in this study as a reliable method that can be used intraoperatively to decide the height of the humerus prosthesis in comminuted fractures of the proximal humerus.

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The Distance Between the Pectoral Major Tendon Insertion and the Top of the Humeral Head as a Landmark for Proper Placement of Hemiarthroplasty in Fractures of the Proximal Humerus

Cited by 5 publications

References 22 publications

A New Method to Determine the Humerus Height and Humeral Head Retroversion for Hemiarthroplasty

A New Method to Determine the Humerus Height and Humeral Head Retroversion for Hemiarthroplasty

Anatomic placement of shoulder prosthesis for complex proximal humerus fractures: A modified method for hemiarthroplasty

The Distance between the Pectoralis Major Tendon Insertion and the Top of the Humeral Head is a Reliable Landmark: An Anatomic Study

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