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Determining humeral retroversion with computed tomography.

P Hernigou1, F Duparc, A Hernigou

  • 1Service d'Orthopédie et de Traumatologie, Université Paris XII, Hôspital Henri Mondor, 51, Avenue du Mal. de Lattre de Tassigny, 94010 Creteil, France.

The Journal of Bone and Joint Surgery. American Volume
|October 16, 2002
PubMed
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Computed tomography (CT) reliably measures humeral torsion angle using anatomical landmarks. This technique offers greater accuracy than traditional surgical methods for assessing humerus rotation, especially in cases of fracture or arthritis.

Area of Science:

  • Orthopedic surgery
  • Radiology
  • Anatomy

Background:

  • Accurate measurement of humeral torsion is crucial for surgical planning and evaluating deformities.
  • Existing methods for determining humeral retroversion can be imprecise, particularly during surgical procedures.

Purpose of the Study:

  • To develop and standardize a computed tomography (CT) imaging technique for measuring humeral torsion angle.
  • To identify reliable anatomical landmarks on CT scans for surgical application.

Main Methods:

  • Computed tomography (CT) scans of 120 cadaveric humeri were analyzed.
  • Humeral retroversion was measured using the orientation of the proximal articular surface relative to the transepicondylar line and forearm axis.
  • The CT method was validated by comparing measurements with direct specimen measurements and testing in patients undergoing shoulder arthroplasty.

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Main Results:

  • The CT method demonstrated good reproducibility, with an interclass correlation coefficient between 0.85 and 0.90.
  • Significant differences were observed between measurements using the epicondylar axis (17.6°) and a line perpendicular to the forearm axis (28.8°).
  • Humeral torsion angle showed minimal variation between the two humeri of the same individual (mean difference of 2.1°).

Conclusions:

  • Computed tomography (CT) provides a reliable and accurate method for measuring proximal humeral retroversion.
  • This CT-based technique is superior to palpation or goniometric measurements for surgical assessment.
  • CT is valuable for quantifying humeral rotation in cases of malunited fractures or severe arthritic deformities.