Abstract: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 di… Show more
“…A previous anatomical analysis reported that the superior margin of the humeral head articular surface is normally superior to the top of the greater tuberosity by 5-10 mm. 17 , 21 As per these reports, we defined malalignment as HHH <0 mm or >10 mm (poor HHH) and the anatomical HHH as that between 0 mm and 10 mm (good HHH). Figure 2 X-ray images of the humeral head.…”
“…A previous anatomical analysis reported that the superior margin of the humeral head articular surface is normally superior to the top of the greater tuberosity by 5-10 mm. 17 , 21 As per these reports, we defined malalignment as HHH <0 mm or >10 mm (poor HHH) and the anatomical HHH as that between 0 mm and 10 mm (good HHH). Figure 2 X-ray images of the humeral head.…”
“…The important of intraoperatively restoring anatomic humeral height, humeral version, and tuberosity reconstruction were highlighted to improve outcomes after hemiarthroplasty for shoulder fracture (9,10).The nonanatomic reduction of the tuberosity in the horizontal may result in insurmountable postoperative motion restriction (11). There are some published methods of restoring the appropriate humeral length for arthroplasty, such as preoperative plan according to the calcar of non-injured extremity, landmark using medial calcar of proximal humeral fracture, reference using pectoralis major tendon, and the Gothic arch based on radiographs (12)(13)(14).…”
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.Trial registration: https://doi.org/10.1186/ISRCTN28175069.
“…The important of intraoperatively restoring anatomic humeral height, humeral version, and tuberosity reconstruction were highlighted to improve outcomes after hemiarthroplasty for shoulder fracture (9,10).The nonanatomic reduction of the tuberosity in the horizontal may result in insurmountable postoperative motion restriction (11). There are some published methods of restoring the appropriate humeral length for arthroplasty, such as preoperative plan according to the calcar of non-injured extremity, landmark using medial calcar of proximal humeral fracture, reference using pectoralis major tendon, and the Gothic arch based on radiographs (12)(13)(14). However, there are some obstructions during surgery: preoperative anteroposterior radiographs of the injured and the contralateral humerus, the break off of pectoralis major tendon for exposure of fracture, repeated intraoperative radiographs.…”
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.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
