Measurement Methods for Humeral Retroversion Using Two-Dimensional Computed Tomography Scans: Which Is Most...

Area of Science:

• Orthopedic Surgery
• Radiology
• Anatomy

Background:

• Humeral retroversion measurement varies between individuals.
• Multiple measurement techniques exist for humeral retroversion.
• Standardization of humeral retroversion assessment is crucial in orthopedic procedures.

Purpose of the Study:

• To compare the concordance and reliability of five novel humeral retroversion measurement methods against the standard technique.
• To evaluate the accuracy of different 2D computed tomography (CT) based humeral version assessment methods.
• To identify the most reliable alternative method for measuring humeral retroversion.

Main Methods:

• Analysis of 2D computed tomography (CT) scans from 21 patients undergoing shoulder arthroplasty.
• Utilized the elbow transepicondylar axis as a distal reference point.
• Compared the standard humeral head axis method with five alternative proximal reference point methods, including bicipital groove and contralateral measurements.

Main Results:

• All five tested methods demonstrated excellent agreement and reliability (inter- and intraobserver reliability > 0.75) for humeral retroversion measurement.
• Method 1 (posterior margin of the bicipital groove) exhibited the highest concordance with the standard measurement.
• Statistically significant differences were noted between the standard method and methods 2, 3, and 4 in some observers.

Conclusions:

• Humeral version measurement using the posterior margin of the bicipital groove (Method 1) is highly concordant with the standard method.
• All evaluated methods offer reliable humeral retroversion measurements on CT scans.
• Method 1 presents a viable alternative for consistent humeral retroversion assessment in clinical practice.