Related Experiment Video
Updated: Jul 10, 2025
10:10
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
43.2K
Subpectoral proximal humeral anatomy: Guidance to decrease risk of fracture following subpectoral biceps tenodesis
Hanbin Wang1, Hailey P Huddleston1, Joey S Kurtzman1
1Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York, USA.
Shoulder & Elbow
|November 20, 2023
Summary
This study determined safe drilling angles for biceps tenodesis to prevent humeral fractures. Surgeons should limit deviation from the perpendicular approach to reduce the risk of unicortical drilling and complications.
Area of Science:
- Orthopedic Surgery
- Anatomy
- Biomedical Engineering
Background:
- Biceps tenodesis is a common procedure for shoulder and biceps issues.
- Humeral fracture is a serious complication associated with biceps tenodesis.
- Understanding proximal humeral anatomy is crucial for surgical safety.
Purpose of the Study:
- To assess proximal humeral cortical thickness.
- To identify optimal angles for drilling during biceps tenodesis.
- To minimize the risk of humeral fracture during the procedure.
Main Methods:
- Computed tomography (CT) scans of eight cadaveric humeri were analyzed.
- A metallic marker indicated the subpectoral tenodesis site.
- Cortical thickness and angular safe zones for reaming were determined.
Main Results:
- The thickest cortical regions are along the bicipital groove ridges.
- Angles of 29.2° medially and 21.6° laterally from the deepest groove avoided unicortical drilling with a 7 mm reamer.
- Safe zones varied slightly proximal and distal to the standard tenodesis site.
Conclusions:
- Surgeons should limit medial deviation to 23° and lateral deviation to 11° from perpendicular.
- Adhering to these angular limits can prevent unicortical tunnels.
- This anatomical guidance aims to reduce the incidence of humeral fractures during biceps tenodesis.
Related Concept Videos
01:19Bones of the Upper Limb: Humerus
3.3K
The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...
3.3K
01:31Muscles that Move the Arm
1.8K
Nine muscles are involved in arm movements. Two of these, the pectoralis major and latissimus dorsi, originate from the axial skeleton and are called axial muscles. The other seven originate from the scapula and are called the scapular muscles.
The pectoralis major has two origins. Its clavicular head originates on the medial half of the clavicle. In contrast, the sternocostal head originates on the costal cartilages of ribs 1-6, the sternum, and the aponeurosis of the external oblique of the...
The pectoralis major has two origins. Its clavicular head originates on the medial half of the clavicle. In contrast, the sternocostal head originates on the costal cartilages of ribs 1-6, the sternum, and the aponeurosis of the external oblique of the...
1.8K