Repositioning of the humeral tuberosities can be guided by pectoralis major insertion

In complex proximal humerus fractures, positioning of the tuberosities can be a challenge. This study demonstrates the constant angle between the pectoralis major (PM) and the medial lip of the bicipital groove (BG) on the horizontal axial plane. This angle can be used to determine the rotation, as...

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Autores principales: Cikes, Alec, Trudeau-Rivest, Étienne, Canet, Fanny, Hébert-Davies, Jonah, Rouleau, Dominique M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Milan 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4278969/
https://www.ncbi.nlm.nih.gov/pubmed/25524132
http://dx.doi.org/10.1007/s11751-014-0205-z
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author Cikes, Alec
Trudeau-Rivest, Étienne
Canet, Fanny
Hébert-Davies, Jonah
Rouleau, Dominique M.
author_facet Cikes, Alec
Trudeau-Rivest, Étienne
Canet, Fanny
Hébert-Davies, Jonah
Rouleau, Dominique M.
author_sort Cikes, Alec
collection PubMed
description In complex proximal humerus fractures, positioning of the tuberosities can be a challenge. This study demonstrates the constant angle between the pectoralis major (PM) and the medial lip of the bicipital groove (BG) on the horizontal axial plane. This angle can be used to determine the rotation, as well as the positioning of the tuberosities, when planning a hemiarthroplasty or a reconstruction. Thirty-one shoulder MRIs were reviewed by three independent observers. The measurements were taken by superposing the axial cut of the proximal humerus, at the level of the distal bicipital groove, and the cut at the top of the PM insertion. By aligning the centers of rotation, we could determine the arcs of rotation between the insertion of the PM and the lips of the medial and lateral bicipital groove (MBG and LBG). Both angles were compared in terms of reliability, reproducibility, and precision. The mean PM–MBG angle was 3.7° [standard deviation (SD) 14.7°] and 27.4° (SD 14.4°) for the PM–LBG angle. We obtained good and very good intra-class correlation coefficient (ICC) results for inter- (0.675) and intra-observer (0.793) reliabilities on the medial angle, plus excellent results for the lateral angle (inter-observers 0.962 and intra-observer 0.895). This study demonstrates that the repositioning of humeral tuberosities can be guided by pectoralis major insertion. This will help achieve proper positioning of the metaphysis in relation to the diaphysis during surgery for complex proximal humerus fractures.
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spelling pubmed-42789692014-12-30 Repositioning of the humeral tuberosities can be guided by pectoralis major insertion Cikes, Alec Trudeau-Rivest, Étienne Canet, Fanny Hébert-Davies, Jonah Rouleau, Dominique M. Strategies Trauma Limb Reconstr Original Article In complex proximal humerus fractures, positioning of the tuberosities can be a challenge. This study demonstrates the constant angle between the pectoralis major (PM) and the medial lip of the bicipital groove (BG) on the horizontal axial plane. This angle can be used to determine the rotation, as well as the positioning of the tuberosities, when planning a hemiarthroplasty or a reconstruction. Thirty-one shoulder MRIs were reviewed by three independent observers. The measurements were taken by superposing the axial cut of the proximal humerus, at the level of the distal bicipital groove, and the cut at the top of the PM insertion. By aligning the centers of rotation, we could determine the arcs of rotation between the insertion of the PM and the lips of the medial and lateral bicipital groove (MBG and LBG). Both angles were compared in terms of reliability, reproducibility, and precision. The mean PM–MBG angle was 3.7° [standard deviation (SD) 14.7°] and 27.4° (SD 14.4°) for the PM–LBG angle. We obtained good and very good intra-class correlation coefficient (ICC) results for inter- (0.675) and intra-observer (0.793) reliabilities on the medial angle, plus excellent results for the lateral angle (inter-observers 0.962 and intra-observer 0.895). This study demonstrates that the repositioning of humeral tuberosities can be guided by pectoralis major insertion. This will help achieve proper positioning of the metaphysis in relation to the diaphysis during surgery for complex proximal humerus fractures. Springer Milan 2014-12-19 2014-11 /pmc/articles/PMC4278969/ /pubmed/25524132 http://dx.doi.org/10.1007/s11751-014-0205-z Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Article
Cikes, Alec
Trudeau-Rivest, Étienne
Canet, Fanny
Hébert-Davies, Jonah
Rouleau, Dominique M.
Repositioning of the humeral tuberosities can be guided by pectoralis major insertion
title Repositioning of the humeral tuberosities can be guided by pectoralis major insertion
title_full Repositioning of the humeral tuberosities can be guided by pectoralis major insertion
title_fullStr Repositioning of the humeral tuberosities can be guided by pectoralis major insertion
title_full_unstemmed Repositioning of the humeral tuberosities can be guided by pectoralis major insertion
title_short Repositioning of the humeral tuberosities can be guided by pectoralis major insertion
title_sort repositioning of the humeral tuberosities can be guided by pectoralis major insertion
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4278969/
https://www.ncbi.nlm.nih.gov/pubmed/25524132
http://dx.doi.org/10.1007/s11751-014-0205-z
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