Variations in the retroversion of the humeral head

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

“…The version is altered or exaggerated in presence of glenohumeral pathology like osteoarthritis, rotator cuff tears leading to glenoid wear and bone loss and is associated with instability and ultimately dislocation of the joint. Gordon Edelson [6] where in high right humeral head version was noted. N Matsumura et al [11] evaluated 410 normal shoulders from healthy volunteers for humeral head version and glenoid version on computed tomography scans; reported an average humeral head version of average of 26° ± 11° and glenoid version of 1° ± 3° Both humeral head retroversion and glenoid retroversion were significantly higher on the dominant side and in men than in women in their study.…”

“…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.…”

“…Head axis which is the longitudinal axis joining the superior and inferior most points on articular margin of anatomical neck was marked. HHV angle was measured using the technique described by Edelson [6] where in disarticulated humerus was mounted on wall with anterior tangent to the trochlea parallel to wall, and the angle between wall and humerus head axis was measured using a compass. Each dimension was recorded three times and the mean was considered.…”

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.…”

“…Anteroposterior diameter (HAP), Medio-lateral diameter (HML) and Head height (HH) were measured using vernier caliper. HH is the maximum measurement of humerus head from anatomic neck to dome of head ( Figure1) HAP is the maximum anterior-posterior measurement of humerus head (Figure 2) HML is the maximum medio-lateral measurement of humerus head ( Figure 3) Humerus version (HV) is Angle formed by humerus epicondyle axis and head axis ( Figure 4) the measurement of humeral head retroversion followed the identical technique as described by Edelson [5]. Firstly a line from Superior to Inferior aspect of humeral head was drawn by 3 dot technique described by Edelson.…”