Three-Dimensional Analysis of the Proximal Part of the Humerus: Relevance to Arthroplasty*

Proximal humeral fractures

“…We classified the contact between head (with or without fracture tuberosities) and shaft (diaphysis) by applying the same kind of scale that other authors used for impaction 32 (0 for no contact, 1 for <20% contact, 2 for between 20% and 50% contact, 3 for >50% contact). Humeral head-diaphysis displacement (no displacement/displacement) The fracture was classified as displaced when there is a 1 cm displacement in the lateral/medial direction or anterior/posterior direction of the humeral shaft, 1 or a >30˚ varus/valgus angulation of the humeral head in relation to the cephalodiaphyseal angle of the other shoulder, [3][4][5][6][7][8][9][10] or compared to 130˚ because it is the average cephalodiaphyseal angle 34,35 in the sagittal plane (varus/ valgus) or in the coronal plane (anterior-posterior).…”

“…1 Angular displacement (varus/valgus/without displacement) [3][4][5][6][7][8][9][10] The fracture was considered as an angular displacement when there is a >30˚ varus/valgus angulation of the humeral head in relation to the cephalodiaphyseal angle of the other shoulder, 3-10 or compared to 130˚ because it is the average cephalodiaphyseal angle 34,35 in the saggital plane (varus/valgus). Associated metadiaphyseal fractures (not defined previously) Presence of metaphyseal fractures is defined when there is one fragment or comminute (two or more fragments) with a surface >10 mm.…”

“…34,35 The definition of the a angle, formed by the perpendicular to the diaphysis and the plane of the humeral head and its prognostic value when it is <20˚, indicates a possible angular displacement of these fractures without functional (clinical) sequel. 10 Therefore, we changed the previous Neer criteria of 45˚ displacement to 30˚ in our protocol.…”

Determination of the Native Angles of Glenoid and Humerus Head Version of Adult Skeletons at Karad, Maharashtra, India

“…Researchers have adapted different methods and tools to measure the versions; measurements on dry bone specimens, roentgenograms, 2D and 3D imaging Computed tomography. As an universal method for all shoulder bones fracture or replacement surgery the contra-lateral parameters are considered as a template for correction, however there is enough literature evidence that high inter-specimen and side specific variability exists [5][6][7]. This study therefore is an attempt to evaluate the native version of glenoid and humeral head in the Indian population which would prove useful at the time of actual shoulder replacement surgery.…”

Morphometric Analysis and Surgical Anatomy of Proximal Humerus

“…As a general method for all proximal humerus fractures or replacement surgery, we use the contra-lateral humerus as the template for correction. But there is enough literature evidence that high inter-specimen and side specific variability exists [4,5,6]. Variations in humeral version and dimensions should be considered at the time of actual replacement surgery.…”