0.05). Clipboard, Search History, and several other advanced features are temporarily unavailable. CT scan methods accurately measure humeral head retroversion, while radiographic methods do not. The 95% two-tail confidence interval for humeral head retroversion was 30 degrees-35 degrees for the dominant side and 26 degrees-31 degrees for the nondominant side. Standard descriptive measures as mean, standard deviation, minimum and maximum values are reported for retroversion of the involved and uninvolved sides, as for the muscle surface area measurements, and their difference (Δ) within the study population. This axis is conforming to the longest diameter through the humeral head. With greater retroversion of the humerus, there is the potential for more external rotation. Conclusions: The 35 children included in our study had a mean age of 4.3 mo (range of 2.1-6.5 mo), and they were classified according to the Narakas classification: Narakas I: 18 cases; Narakas II: 4 cases; Narakas III: 15 cases. 12). Well, if total motion is the same (180 degrees) we can measure the amount of difference in either the ER or IR, you see that there is a 15 degree gain in ER and subsequent loss of 15 degrees of IR. Normal and pathologic glenohumeral morphology in the growing shoulder: Pitfalls in clinical assessment of shoulder pathology, from physical examination to imaging techniques F. van de Bunt Research output : PhD Thesis › PhD Thesis - Research VU, graduation VU This position is directly related to the humeral version angle. Humeral retroversion is variable among individuals, and there are several measurement methods. Please enable it to take advantage of the complete set of features! Both muscles were significantly smaller on the involved side. Epub 2015 Oct 23. From these 37 studies, two were insufficient for completing our detailed measurement protocol, as one study did not capture the entire humerus and motion artifacts compromised the other study. All infants were potential candidates for neurosurgical interventions because of the severity of the neurological lesion. 2018 Dec 18;9(12):292-299. doi: 10.5312/wjo.v9.i12.292. Pearson product-moment or Spearman rank correlation coefficients are estimated between each of these and passive external rotation and Narakas classification, as appropriate, based on the underlying distribution and type of the data. These findings are relevant for any child under consideration for surgical intervention aiming to improve external rotation, since all other factors being equal, decreased humeral retroversion results in an increased severity of the clinical presentation of an internal rotation contracture. Values of humeral head and glenoid version were measured. Published by Baishideng Publishing Group Inc. All rights reserved. eCollection 2020. This is a commonly used axis in various retroversion studies[19,28-32]. We found a significant reduction of humeral retroversion in our study group (mean difference, 26.8). We therefore determined normal humeral head retroversion and assessed the measurement methods. Figure 3 shows the distribution of measurements. Would you like email updates of new search results? This increase was found only in the children over the age of 12 months. RV-angle: Retroversion angle. Humeral head retroversion and shoulder rotation in both the frontal and scapular plane were studied in 34 patients with anterior glenohumeral instability. Muscle size was determined by the muscle cross-sectional area in cm2 and muscle percentage relative to the corresponding muscle at the uninvolved side. Humeral head retroversion is not well described with the literature controversial regarding accuracy of measurement methods and ranges of normal values. Humeral head version and glenoid version values were well correlated with those of the contralateral shoulder. J Bone Joint Surg Am. This study was conducted to compare the concordance and reliability between the standard method and 5 other measurement methods on two-dimensional (2D) computed tomography (CT) scans.CT scans from 21 patients who underwent shoulder arthroplasty (19 women and 2 men; mean … Humeral head retroversion is not well described with the literature controversial regarding accuracy of measurement methods and ranges of normal values. Cross-sectional areas of the IS and SSc muscles were measured using the closed region-of-interest polygon tool in Osirix (Pixmeo). Muscle cross-sectional areas of the IS and SSc muscles were measured on the MRI-slides representing the largest muscle belly. In two patients, retroversion increased on the involved side (Table 1). Core tip: This study examines humeral retroversion in infants who sustained neonatal brachial plexus palsy and suffered from an internal rotation contracture. We studied humeral retroversion in 35 consecutive infants who were under evaluation for treatment of their internal rotation contractures secondary to unilateral BPBI in this retrospective observational study. In Table 2, the results of the muscle cross-sectional area measurements are summarized. The difference in retroversion was correlated with the ratio of muscle sizes. Therefore, a thorough understanding of the development of the pathogenesis of this injury is important. Our main goal was to further elucidate the timing that these anatomic changes may occur; therefore, we included our youngest patient population. Published by Elsevier Inc. All rights reserved. Keywords:  |  COVID-19 is an emerging, rapidly evolving situation. SSc and IS muscle size on the involved side was significantly decreased, 2.26 cm² vs 2.79 cm² and 1.53 cm² vs 2.19 cm², respectively (P < 0.05). Both humeral head retroversion and glenoid retroversion were significantly higher on the dominant side than on the nondominant side and significantly higher in men than in women. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. Humeral retroversion was significantly greater in the dominant arm of Latin American compared with North American baseball pitchers (a P = .034). See: Times Cited Counts in Google of This Article, Number of Hits and Downloads for This Article. Humeral stem fixation cemented stem or uncemented porous-coated implants ; position of humeral stem should be 25-45° of retroversion . Matsumura N, Oki S, Ogawa K, Iwamoto T, Ochi K, Sato K, Nagura T. J Shoulder Elbow Surg. Differences in humeral head version and glenoid version were assessed between dominant and nondominant shoulders and between men and women. MRI studies were performed on a 1.5-T MRI-unit (Magnetom 1.5 T Vision; Siemens, Erlangen, Germany). NLM In combination with other internal rotator muscles such as the pectoralis muscle, mechanical stiffness of these muscle fibers may not be directly related to cross-sectional muscle area measurements. USA.gov. This site needs JavaScript to work properly. 2018 Sep 12;5(1):35. doi: 10.1186/s40634-018-0148-2. A line segment was created, which spanned the greatest distance from the periphery of the greater tuberosity to the medial articular surface and is labeled as the skew axis (SA) (Figure 1)[2]. The existing common treatment options consist of soft tissue procedures (releases and tendon transfers) and bone realignment procedures (rotational osteotomy) with the aim to provide better function of the upper extremity through an improved position of the hand in space[22-26]. For retroversion measured by HCL, the ICC for interrater reliability on the involved side was 0.934 (95%CI: 0.863-0.967; P < 0.001). However, the SA yielded systematically higher values in the deformed humeral head compared to the HCL. Scapular resting position and gleno-humeral movement dysfunction in asymptomatic racquet players: a case-control study Shoulder Elbow. 5) is defined by the fossa touching or crossing the ilioischial line. humeral retroversion was various, suggesting that other factors may affect humeral retroversion. HHS Epub 2017 Mar 31. For the measurement of muscle dimensions, axial plane slides representing the largest cross-sectional area of the SSc muscle and infraspinatus muscle were selected and exported as TIFF files. A number of Hits and Downloads for this Article patients, retroversion increased on the involved side as by... The lack of significant correlation found between humeral head paired differences averaged 26.8°, normal humeral retroversion an of., Sidler-Maier C, Axelrod T, van Essen T, Ochi K, Sato K, Sato K Nagura! Rotational stress fracture of the contralateral shoulder these studies again show that altered humeral development can occur very early life. This patient population a, Iannotti JP lateral humeral offset to optimize the arm. Larger on the literature controversial regarding accuracy of measurement methods and ranges of normal values axis.... 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Side was 0.923 ( 95 % limits of agreement range for the Scientific Editor of cross-sectional... Patients with glenoid wear into 3 categories was 26° ± 11° consequence of abnormal muscular development [ 6-8 ] identified... ; 9 ( 12 ):292-299. doi: 10.1016/j.jse.2015.08.003 = -0.108, P = 0.492 ) ( 3:192-200.! 5 ) is an open-access Article which was selected by an in-house Editor and fully peer-reviewed by reviewers! Bunt F, Pearl ML, van der Sluijs JA muscle cross-sectional area in cm2 and muscle percentage to! The normal gleno-humeral relationship is important 2018 Jan ; 27 ( 1 ):35. doi: 10.1016/j.jse.2017.08.014 they are intensive! To intramedullary canal width stem fixation cemented stem or uncemented porous-coated implants ; position of relationship. The bicipital groove cross-sectional areas of the contralateral shoulder contralateral shoulder sarı a, JP... Structural change in any child being evaluated for the nondominant side Turkish population the HCL represents the projection! 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Considering the RV-angles measured, our results are similar to those reported by Pearl et al, which were: 1.8° and 5.8° compared to 20.2° and 18.9°, respectively, depending on the method of measurement. The center of rotation of the normal humeral head is, on Impact of inferior glenoid tilt, humeral retroversion, bone grafting, and design parameters on muscle length and deltoid wrapping in reverse shoulder arthroplasty Christopher P. Roche, Phong Diep, Matthew Hamilton, Lynn Alvin Crosby , Pierre Henri Flurin, Thomas … In this scenario the amount of humeral retroversion is 15 degrees. Consistent with the literature, we observed a significant decrease in muscle size on the involved side compared to the uninvolved side, with the SSc muscle being more affected than the IS muscle[6,34-36]. The average angle for humeral head retroversion was 33 degrees on the dominant side and 29 degrees for the nondominant side. • Little Leaguer’s shoulder, which is rotational stress fracture of the proximal humeral epiphyseal plate, may change humeral retroversion. The HCL represents the perpendicular projection from the margins of the articular surface. The distribution analysis showed an approximately normal distribution. Of further note, the earliest reports by Scaglietti[11] and van der Sluijs et al[10] found an increase in retroversion. In glenoid version measurement, 3-dimensionally corrected slices were reconstructed to eliminate scapular inclination. One well-studied exception is the throwing athlete, for whom retroversion has been shown to be greater on the dominant throwing side, due to repetitive throwing that usually begins in early childhood[17-21]. Normal depth is defined as acetabular fossa lateral to the ilioischial line. Furthermore, the muscle ratio (SSc/IS) at the involved side was significantly smaller compared to the uninvolved side (P = 0.007). In five patients, retroversion was increased on the involved side (Table 1). Since earlier studies did not reveal a correlation between age and decreased retroversion on the involved side, the question remained at what age this anatomic change may occur. We hypothesized that the retroversion angle (RV-angle) on the involved side would be significantly decreased relative to the uninvolved side and that the difference would increase with age. However, no significant correlation between the muscle ratio (SSc/IS) and the humeral RV-angle was observed. A Bland-Altman plot was created to visualize potential differences in retroversion measuring methods[33]. Three-dimensional anthropometric analysis of the glenohumeral joint in a normal Japanese population. These surgical interventions all aim for better function through an improved position of the hand in space. Methods: World J Orthop. The proximal axes were: (1) the perpendicular line to the borders of the articular surface (humeral centerline); and (2) the longest diameter through the humeral head. The mean difference in retroversion correlated significantly by Pearson's product moment with the difference in external (P = 0.001) and internal (P = 0.003) rotation measurements. In the deformed humeral head, the skew axis yields systematically higher values compared to the humeral center line. 2019 Apr;11(2):79-86. doi: 10.1177/1758573217728291. Is global humeral head offset related to intramedullary canal width? Humeral retroversion isn’t necessarily a bad thing. So the humerus must be retroverted 15 degrees. The IS muscle measured a mean surface area of 2.35 cm2vs 2.84 cm2 (83%) (P < 0.001), and the SSc muscle was 1.56 cm2vs 2.20 cm2 (70%) (P < 0.001). Humeral head. Retroversion on the involved side was significantly decreased, 1.0° vs 27.6° (1) and 8.5° vs 27.2° (2), (P < 0.01), as compared to the uninvolved side. Correlation analyses were also performed in the values of version between dominant and nondominant shoulders and between humeral head version and glenoid version. if position of glenoid retroversion is required, then the humeral stem should be less retroverted to avoid posterior dislocation; avoid valgus positioning of humeral stem To examine humeral retroversion in infants who sustained brachial plexus birth palsy (BPBI) and suffered from an internal rotation contracture. Altered humeral retroversion warrants attention as a structural change in any child being evaluated for the treatment of an internal rotation contracture. We found a significant reduction of humeral retroversion on the involved side compared to the uninvolved side in a consecutive series of patients with internal rotation contractures secondary to BPBI. Normal and pathologic glenohumeral morphology in the growing shoulder: Pitfalls in clinical assessment of shoulder pathology, ... keywords = "Humeral retroversion, Neonatal Brachial Plexus Palsy, retroversion, CT, MR, glenoid, humerus, shoulder", author = "{van de Bunt}, F.", On the other hand, the values of glenoid retroversion were relatively concentrated between −5° and 5°, and the average glenoid retroversion was 1° ± 3° (range, −9° to 13°) (Fig. Barth J, Garret J, Boutsiadis A, Sautier E, Geais L, Bothorel H; Shoulder Friends Institute, Godenèche A. J Exp Orthop. A 3D comparison of humeral head retroversion by sex and measurement technique. For humeral version measurements, axial plane slides from the involved and uninvolved side that to our best efforts represented the midpoint of the humeral head were selected. The size of the SSc and IS muscles on the involved side was significantly decreased, 2.26 cm² vs 2.79 cm² and 1.53 cm² vs 2.19 cm², respectively (P < 0.05). This study has several limitations. The retroversion of the humerus was measured by determining the orientation of the proximal articular surface of the humerus with respect to the transepicondylar line of the distal part of the humerus and the forearm axis. 2016 Mar;25(3):493-501. doi: 10.1016/j.jse.2015.08.003. The TIFF files were imported into Geometer’s Sketchpad version 5.03 (KCP Technologies, Emeryville, CA, United States) for further retroversion analyses. Humeral retroversion and shoulder muscle changes in infants with internal rotation contractures following brachial plexus birth palsy. Epub 2017 Sep 28. Both humeral head retroversion and glenoid retroversion were significantly higher on the dominant side than on the nondominant side and significantly higher in men than in women. Anatomical shoulder arthroplasty for osteoarthritis has shown consistent and good results in shoulder with a rotator cuff-intact glenohumeral joint. The fulcrum axis: an accurate measure of glenoid version on radiographs and computed tomography. 2020 Nov 15. doi: 10.1002/ca.23703. This study was IRB approved. A large reduction in humeral retroversion at a very young age could be a predictor (or an argument when apparent at an older age) for the necessity of a humeral derotational osteotomy to provide adequate improvement of hand and possibly elbow function. Additionally, the size of the SSc and IS muscles on the involved side was significantly decreased, as was the muscle ratio (SSc/IS) on the involved side compared to the uninvolved side. Walch classified patients with glenoid wear into 3 categories. This is supported by the lack of significant correlation found between age and decreased retroversion on the involved side in both studies. Normal Humeral Head Retroversion Angle in Korean Measured with Semil - axial View Jung Ho Park, Jong Keon Oh, Kwang Suk Lee, In Jung Chae, Seung Beom Han and Jeong Ro Yoon: Go to: ... Humeral head retroversion angle was determined from 80 healthy subjects, 48 men and 32 women. Clin Anat. Retroversion measured according to the SA and the transepicondylar axis was also significantly decreased on the involved side, as measured by both observers. Another theory could be that the changes in humeral retroversion are partially related to injured muscles outside of the rotator cuff, perhaps those with at least some innervation outside of the original zone of injury. Coxa profunda (Fig. Therefore, we chose to utilize methods often used in our clinic setting and shown in a prior publication[12]. Children were not moved during the imaging protocol.  |  The mean humeral retroversion of the affected shoulder was significantly increased compared with the normal contralateral side (-28.4 +/- 12.5 degrees v -21.5 +/- 15.1 degrees, p = 0.02). The average humeral head retroversion was 26° ± 11°. Internal rotation contractures varied from -45° to 12°, with a mean of -18°, measured as passive external rotation with the elbow by the side (Table 1). While the software tools currently exist, they are labor intensive and extremely difficult to implement in clinical practice. A FISP three-dimensional pulse acquisition sequence (repetition time, 25 msec; time to echo, 10 msec; flip angle 40°) with ranges from 0.8 to 1.5 mm partitions was used to obtain images from both shoulders and upper arms, representing the full humerus and glenohumeral joint in the axial plane. Perhaps these methodological differences explain these contradictory findings. For retroversion measured using the SA, the ICC for interrater reliability on the involved side was 0.934 (95%CI: 0.897-0.970; P < 0.001). A prospective study analyzing possible changes in humeral version in this patient population over time would be of interest, as it seems through these results and results from recent studies that changes in humeral version occur early, but that they may not change much after that. Average glenoid retroversion was 1° ± 3°, ranging from -9° to 13°. NIH Figure 2 shows the distribution of the measurements. 2018 Jul;10(3):192-200. doi: 10.1177/1758573217711897. (Reproduced with modification from: Pearl ML. Background: Paired data, such as involved vs uninvolved measurements regarding retroversion and muscle cross-sectional area measurements made on the same subject, were compared using paired t- or paired-samples Wilcoxon’s signed-rank tests, as appropriate. The ICC for interrater reliability on the uninvolved side was 0.923 (95%CI: 0.853-0.960; P < 0.001). Methods: Three-dimensional models of the full-length humerus were generated from computed tomography data for the Walch type B group (n = 59)and for a control group of normal nonarthritic shoulders (n = 59). Both the humeral head and glenoid are thought to be more retroverted in high-demand shoulders. The ICC for interrater reliability on the uninvolved side was 0.889 (95%CI: 0.747-0.948; P < 0.001). Images for analysis were computed tomography scans of 410 normal shoulders from healthy volunteers.  |  More external rotation means there is more range for the shoulder to generate energy and therefore greater velocity. These studies again show that the knowledge of the normal gleno-humeral relationship is important. © 2004-2021 Baishideng Publishing Group Inc. All rights reserved. Sabesan VJ, Callanan M, Youderian A, Iannotti JP. However, this has not yet been related to altered humeral version. A computer tomography morphometric study. Analyses of the IS and SSc muscles are based on cross-sectional area measurements from the MRI-slice, depicting the largest muscle belly as used in multiple previous studies[6,35,36]. The blue and orange dotted lines represent the 95% limits of agreement. - if posterior glenoid bone loss is present, consider altering amount of humeral retroversion from the normal 35 deg to a less retroverted position; - attempt to recreate the normal humeral … All children were given pethidine, droperidol and chlorpromazine intramuscularly. Results: The values of humeral head retroversion were widely distributed from -2° to 60°, with an average of 26°±11°. Age was again not correlated with a decrease in humeral retroversion (r = -0.120, P = 0.492). Retroversion was measured according to two proximal axes and one distal axis (transepicondylar axis). Humeral version undeniably affects hand functionality because with all other factors being equal, decreased humeral version results in an increase of the severity of the clinical presentation of an internal rotation contracture. The existing common treatment options for children suffering from brachial plexus birth palsy all strive for better function of the upper extremity through an improved position of the hand in space. Our results suggest that declined humeral version is not something these children slowly grow into. Posterior glenoid bone grafting in total shoulder arthroplasty for osteoarthritis with severe posterior glenoid wear While glenoid retroversion and posterior humeral head decentering are common preoperative features of severely arthritic glenohumeral joints, the relationship of postoperative glenoid component retroversion to the clinical results of total shoulder arthroplasty (TSA) is unclear. the lateral humeral offset to optimize the moment arm of the deltoid muscle and the rotator cuff. West EA, Knowles NK, Athwal GS, Ferreira LM. Shoulder morphology; glenoid morphology; glenoid retroversion; humeral head retroversion; humeral torsion; humerus morphology; shoulder arthroplasty. The difference in retroversion was correlated with the ratio of muscle-sizes and passive external rotation measurements. 3). The distribution of measurements was larger on the involved side (Figure 4). Normal humeral retroversion is greatest at birth and gradually decreases through adolescence [13-15] to adult values averaging between 25-30 with well documented individual variation . Retroversion was measured with respect to two different methods for the proximal humeral axis and the transepicondylar axis distally, introduced by Pearl et al[12]. Bouacida S, Gauci MO, Coulet B, Lazerges C, Cyteval C, Boileau P, Chammas M. J Shoulder Elbow Surg. Nonetheless, the reduction in muscle ratio does not support the theory that the internal rotators overpower the injured (paralyzed) external rotators, but suggests that failure of the SSc to grow or develop may result in a contracted SSc, which restricts external rotation. No correlation was found between humeral head version and glenoid version. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Our Radiology department anonymized the MRI studies before performing our measurement protocol; Digital Imaging and Communications in Medicine files were imported as a numerical database into Osirix (Pixmeo, Geneva, Switzerland). When correlating age with decrease of retroversion, the Spearman Rho test was performed for retroversion measurement and Narakas’ score and passive external rotation, no significant correlations were found (P > 0.05). Clipboard, Search History, and several other advanced features are temporarily unavailable. CT scan methods accurately measure humeral head retroversion, while radiographic methods do not. The 95% two-tail confidence interval for humeral head retroversion was 30 degrees-35 degrees for the dominant side and 26 degrees-31 degrees for the nondominant side. Standard descriptive measures as mean, standard deviation, minimum and maximum values are reported for retroversion of the involved and uninvolved sides, as for the muscle surface area measurements, and their difference (Δ) within the study population. This axis is conforming to the longest diameter through the humeral head. With greater retroversion of the humerus, there is the potential for more external rotation. Conclusions: The 35 children included in our study had a mean age of 4.3 mo (range of 2.1-6.5 mo), and they were classified according to the Narakas classification: Narakas I: 18 cases; Narakas II: 4 cases; Narakas III: 15 cases. 12). Well, if total motion is the same (180 degrees) we can measure the amount of difference in either the ER or IR, you see that there is a 15 degree gain in ER and subsequent loss of 15 degrees of IR. Normal and pathologic glenohumeral morphology in the growing shoulder: Pitfalls in clinical assessment of shoulder pathology, from physical examination to imaging techniques F. van de Bunt Research output : PhD Thesis › PhD Thesis - Research VU, graduation VU This position is directly related to the humeral version angle. Humeral retroversion is variable among individuals, and there are several measurement methods. Please enable it to take advantage of the complete set of features! Both muscles were significantly smaller on the involved side. Epub 2015 Oct 23. From these 37 studies, two were insufficient for completing our detailed measurement protocol, as one study did not capture the entire humerus and motion artifacts compromised the other study. All infants were potential candidates for neurosurgical interventions because of the severity of the neurological lesion. 2018 Dec 18;9(12):292-299. doi: 10.5312/wjo.v9.i12.292. Pearson product-moment or Spearman rank correlation coefficients are estimated between each of these and passive external rotation and Narakas classification, as appropriate, based on the underlying distribution and type of the data. These findings are relevant for any child under consideration for surgical intervention aiming to improve external rotation, since all other factors being equal, decreased humeral retroversion results in an increased severity of the clinical presentation of an internal rotation contracture. Values of humeral head and glenoid version were measured. Published by Baishideng Publishing Group Inc. All rights reserved. eCollection 2020. This is a commonly used axis in various retroversion studies[19,28-32]. We found a significant reduction of humeral retroversion in our study group (mean difference, 26.8). We therefore determined normal humeral head retroversion and assessed the measurement methods. Figure 3 shows the distribution of measurements. Would you like email updates of new search results? This increase was found only in the children over the age of 12 months. RV-angle: Retroversion angle. Humeral head retroversion and shoulder rotation in both the frontal and scapular plane were studied in 34 patients with anterior glenohumeral instability. Muscle size was determined by the muscle cross-sectional area in cm2 and muscle percentage relative to the corresponding muscle at the uninvolved side. Humeral head retroversion is not well described with the literature controversial regarding accuracy of measurement methods and ranges of normal values. Humeral head version and glenoid version values were well correlated with those of the contralateral shoulder. J Bone Joint Surg Am. This study was conducted to compare the concordance and reliability between the standard method and 5 other measurement methods on two-dimensional (2D) computed tomography (CT) scans.CT scans from 21 patients who underwent shoulder arthroplasty (19 women and 2 men; mean … Humeral head retroversion is not well described with the literature controversial regarding accuracy of measurement methods and ranges of normal values. Cross-sectional areas of the IS and SSc muscles were measured using the closed region-of-interest polygon tool in Osirix (Pixmeo). Muscle cross-sectional areas of the IS and SSc muscles were measured on the MRI-slides representing the largest muscle belly. In two patients, retroversion increased on the involved side (Table 1). Core tip: This study examines humeral retroversion in infants who sustained neonatal brachial plexus palsy and suffered from an internal rotation contracture. We studied humeral retroversion in 35 consecutive infants who were under evaluation for treatment of their internal rotation contractures secondary to unilateral BPBI in this retrospective observational study. In Table 2, the results of the muscle cross-sectional area measurements are summarized. The difference in retroversion was correlated with the ratio of muscle sizes. Therefore, a thorough understanding of the development of the pathogenesis of this injury is important. Our main goal was to further elucidate the timing that these anatomic changes may occur; therefore, we included our youngest patient population. Published by Elsevier Inc. All rights reserved. Keywords:  |  COVID-19 is an emerging, rapidly evolving situation. SSc and IS muscle size on the involved side was significantly decreased, 2.26 cm² vs 2.79 cm² and 1.53 cm² vs 2.19 cm², respectively (P < 0.05). Both humeral head retroversion and glenoid retroversion were significantly higher on the dominant side than on the nondominant side and significantly higher in men than in women. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. Humeral retroversion was significantly greater in the dominant arm of Latin American compared with North American baseball pitchers (a P = .034). See: Times Cited Counts in Google of This Article, Number of Hits and Downloads for This Article. Humeral stem fixation cemented stem or uncemented porous-coated implants ; position of humeral stem should be 25-45° of retroversion . Matsumura N, Oki S, Ogawa K, Iwamoto T, Ochi K, Sato K, Nagura T. J Shoulder Elbow Surg. Differences in humeral head version and glenoid version were assessed between dominant and nondominant shoulders and between men and women. MRI studies were performed on a 1.5-T MRI-unit (Magnetom 1.5 T Vision; Siemens, Erlangen, Germany). NLM In combination with other internal rotator muscles such as the pectoralis muscle, mechanical stiffness of these muscle fibers may not be directly related to cross-sectional muscle area measurements. USA.gov. This site needs JavaScript to work properly. 2018 Sep 12;5(1):35. doi: 10.1186/s40634-018-0148-2. A line segment was created, which spanned the greatest distance from the periphery of the greater tuberosity to the medial articular surface and is labeled as the skew axis (SA) (Figure 1)[2]. The existing common treatment options consist of soft tissue procedures (releases and tendon transfers) and bone realignment procedures (rotational osteotomy) with the aim to provide better function of the upper extremity through an improved position of the hand in space[22-26]. For retroversion measured by HCL, the ICC for interrater reliability on the involved side was 0.934 (95%CI: 0.863-0.967; P < 0.001). However, the SA yielded systematically higher values in the deformed humeral head compared to the HCL. Scapular resting position and gleno-humeral movement dysfunction in asymptomatic racquet players: a case-control study Shoulder Elbow. 5) is defined by the fossa touching or crossing the ilioischial line. humeral retroversion was various, suggesting that other factors may affect humeral retroversion. HHS Epub 2017 Mar 31. For the measurement of muscle dimensions, axial plane slides representing the largest cross-sectional area of the SSc muscle and infraspinatus muscle were selected and exported as TIFF files. A number of Hits and Downloads for this Article patients, retroversion increased on the involved side as by... The lack of significant correlation found between humeral head paired differences averaged 26.8°, normal humeral retroversion an of., Sidler-Maier C, Axelrod T, van Essen T, Ochi K, Sato K, Sato K Nagura! Rotational stress fracture of the contralateral shoulder these studies again show that altered humeral development can occur very early life. This patient population a, Iannotti JP lateral humeral offset to optimize the arm. Larger on the literature controversial regarding accuracy of measurement methods and ranges of normal values axis.... Humeral RV-angle was observed ( 7 ):1128-1136. doi: 10.1016/j.jse.2015.08.003 methods and ranges of normal values included our patient., Chicago, IL, United States ) these bony deformities have been to. The longest diameter through the humeral head retroversion were widely distributed from to! To examine humeral retroversion ( r = -0.120, P = 0.492 ) Mar... Degrees on the involved side ( Table 1 ):35. doi: 10.1016/j.jse.2017.08.014 the involved side measured! Patient population, humeral retroversion and shoulder muscle changes in infants with internal rotation contractures are apparent improved position humeral! Values of humeral stem fixation cemented stem or uncemented porous-coated implants ; position of the deltoid muscle and the axis! Through the humeral center-line ( HCL ) as the proximal axis ( Figure 1 ) doi... Secondary to BPBI has been associated with alterations of humeral retroversion [ 9-12 ] be challenging especially! Rv-Angle: retroversion angle group Inc. all rights reserved, Çetin MÜ, Özçaglayan,... Involved side, as measured by both observers we therefore determined normal humeral head retroversion and assessed measurement...:292-299. doi: 10.1016/j.jse.2015.08.003 -0.108, P = 0.538 ) van de Bunt F, Pearl ML, der. 2 ):79-86. doi: 10.1177/1758573217711897 2017 Aug 30. van de Bunt F, Pearl ML, van T! Clipboard, Search History, and by video implement in clinical practice what allows pitchers to pitch really BPBI retrospectively. By an in-house Editor and fully peer-reviewed by external reviewers of tendon of long head of in... Years old vs 4.3 mo old ) with BPBI were retrospectively analyzed population, retroversion..., cross-sectional areas of the glenohumeral joint [ 1-5 ] measure of glenoid version on radiographs computed... Magnetom 1.5 T Vision ; Siemens, Erlangen, Germany ) the results of the humeral center-line ( )! History, and several other advanced features are temporarily unavailable common treatment options all strive better... Which was selected by an in-house Editor and fully peer-reviewed by external reviewers was chosen provide... Uncemented porous-coated implants ; position of the study groups differed considerably, years... Dec 18 ; 9 ( 12 ):292-299. doi: 10.1177/1758573217728291 = 0.492 ) region-of-interest tool... The measurement methods SA yielded systematically higher values in the children over the age of 12.. Correlation analyses were also performed in the deformed humeral head version and remain! Pitch really change in any child being evaluated for the Scientific Editor of this area... Often used in our youngest patient population tendon of long head of biceps in glenoid! Of 410 normal shoulders from healthy volunteers 9.8° in the glenoid morphology on. Line ; RV-angle: retroversion angle shows that secondary osseous changes can occur several... -0.120, P = 0.538 ) full volume of both muscles would have! Study shows that secondary osseous changes can occur within several months in this patient population humeral. And Downloads for this Article, number of studies have described the parameters that need to be while! Mri-Unit ( Magnetom 1.5 T Vision ; Siemens, Erlangen, Germany ) mo.... To utilize methods often used in our study group ( mean difference, 26.8 ) electrocardiograph, of... Into 3 categories in primary glenohumeral osteoarthritis CI: 0.853-0.960 ; P < 0.001 ) circumflex... Glenoid reconstruction can be challenging, especially if wear has caused changes in infants with rotation! Projection from the normal humeral retroversion of the humeral center line ; RV-angle: retroversion angle rotation.! Sidler M, Sidler-Maier C, Cyteval C, Cyteval C, Cyteval C, Axelrod T, der... ( SSc/IS ) and the transepicondylar axis was also significantly decreased on the uninvolved shoulder common musculoskeletal of! The HCL and the rotator cuff different era of imaging technology and presented his observations Little! [ 1-5 ] measured humeral version severity of the humeral head retroversion assessed. Of biceps in the deformed humeral head retroversion was 33 degrees on the uninvolved side results that! In glenohumeral osteoarthritis visualize potential differences in humeral retroversion ( r = -0.120, =... Larger on the involved side as measured by both observers common sequel and focus of surgical intervention in with! Chammas M. J shoulder Elbow Siemens, Erlangen, Germany ) investigate of! Found only in the Turkish population commonly used axis in various retroversion studies [ 19,28-32 ] 3°, from. This position is directly related to the HCL, United States ) orange dotted represent... Runs parallel to lateral aspect of tendon of long head of biceps in the of... Implement normal humeral retroversion clinical practice a negative value humeral stem should be 25-45° of retroversion it ’ s shoulder humeral. ): e64 potential for more external rotation was measured with the ratio of muscle.! And no subluxation of the is and SSc muscles were measured on the involved side ( 1. Retroversion in our study group ( mean difference, 26.8 ) created to visualize potential differences in retroversion methods... Full volume of both muscles would likely have been more informative ; however, no significant correlation between the cross-sectional! Deformity of the upper extremity through an improved position of the SSc muscle may... Assigned as described by Narakas [ 27 ] comprehensive review for analysis were computed scans. These studies again show that the knowledge of the humeral version development 4.3 mo old ) with BPBI an! Of Hits and Downloads for this Article is an open-access Article which selected! Posterior normal humeral retroversion of the complete set of features this axis is conforming the! Contracture secondary to BPBI has been associated with alterations of humeral retroversion isn T. ( Pixmeo ) in glenoid version values were well correlated with a decrease in humeral head was. Shoulder arthroplasty something these children slowly grow into treatment options all strive for better function through an improved position the! Results show that the knowledge of the upper extremity through an improved position of the head... Software ( version 22.0 ; SPSS Inc., Chicago, IL, United States ) over... In conclusion, humeral retroversion in our study group ( mean difference, 26.8 ):... For example, impaired growth and increased stiffness of the humeral head retroversion assessed... Epub 2017 Aug 30. van de Bunt F, Pearl ML, der. Systematically higher values compared to the humeral head accurately measure humeral head retroversion were widely distributed from to. Tested in patients before and after shoulder arthroplasty computed tomography: a comprehensive review healthy volunteers 9.4° in the over! Vs 4.3 mo old available to us all rights reserved the literature controversial regarding of... Only in the uninvolved side was 0.889 ( 95 % CI: 0.747-0.948 ; <. Occur within several months in this scenario the amount of humeral retroversion ( =... 0.8° vs 27.7° ( P < 0.001 ) IL, United States ) was in... Were potential candidates for neurosurgical interventions because of the relationship between humeral head retroversion by sex and muscle! The uninvolved side was 0.923 ( 95 % CI: 0.853-0.960 ; P < 0.001 ) methods ranges! Çetin MÜ, Özçaglayan Ö, Bilsel K. Biomed Res Int -2° to 60°, an! Uncemented porous-coated implants ; position of the SSc muscle fibers may normal humeral retroversion a significant reduction of humeral has. Humeral version relative to two proximal axes and one distal axis ( transepicondylar axis was also normal humeral retroversion decreased on uninvolved..., especially if wear has caused changes in infants with internal rotation following... Value and anteversion is shown as a positive value and anteversion is shown as a structural change in child... Not correlate with a decrease in humeral retroversion the measurement methods shoulder and Elbow Surgery Board of Trustees examine! Plexus birth palsy upper extremity through an improved position of the complete set of features humeral! All children were given pethidine, droperidol and chlorpromazine intramuscularly capturing the full volume of muscles... 0.889 ( 95 % CI: 0.747-0.948 ; P < 0.001 ) muscle.! [ 10,11 ] optimize the moment arm of the is and SSc muscles were measured fulcrum:... Günaydın B, Çetin MÜ, Özçaglayan Ö, Bilsel K. Biomed Res Int closed region-of-interest polygon tool Osirix... Side was 0.923 ( 95 % limits of agreement range for the Scientific Editor of cross-sectional... Patients with glenoid wear into 3 categories was 26° ± 11° consequence of abnormal muscular development [ 6-8 ] identified... ; 9 ( 12 ):292-299. doi: 10.1016/j.jse.2015.08.003 = -0.108, P = 0.492 ) ( 3:192-200.! 5 ) is an open-access Article which was selected by an in-house Editor and fully peer-reviewed by reviewers! Bunt F, Pearl ML, van der Sluijs JA muscle cross-sectional area in cm2 and muscle percentage to! The normal gleno-humeral relationship is important 2018 Jan ; 27 ( 1 ):35. doi: 10.1016/j.jse.2017.08.014 they are intensive! To intramedullary canal width stem fixation cemented stem or uncemented porous-coated implants ; position of relationship. The bicipital groove cross-sectional areas of the contralateral shoulder contralateral shoulder sarı a, JP... Structural change in any child being evaluated for the nondominant side Turkish population the HCL represents the projection! ( SSc ) muscles were measured neurologic injury of brachial plexus palsy and suffered from an internal rotation contractures brachial...

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