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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Milan
2014
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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. |
format | Online Article Text |
id | pubmed-4278969 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Springer Milan |
record_format | MEDLINE/PubMed |
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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