The purpose of this study was to evaluate the normal values of humeral head version and glenoid version on computed tomography scans and to clarify their features in the normal glenohumeral joint. Epub 2017 Aug 30. van de Bunt F, Pearl ML, van Essen T, van der Sluijs JA. 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. In conclusion, humeral retroversion has a high likelihood of being significantly decreased in this patient population. For example, impaired growth and increased stiffness of the SSc muscle fibers may have a significant effect on humeral version development. 5) is defined by the fossa touching or crossing the ilioischial line. 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. However, no significant correlation between the muscle ratio (SSc/IS) and the humeral RV-angle was observed. In Table 2, the results of the muscle cross-sectional area measurements are summarized. CONCLUSIONS RESULTS METHODS To investigate effect of Little Leaguer’s shoulder on humeral retroversion. 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 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. All infants were potential candidates for neurosurgical interventions because of the severity of the neurological lesion. 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 … While the software tools currently exist, they are labor intensive and extremely difficult to implement in clinical practice. Therefore, a thorough understanding of the development of the pathogenesis of this injury is important. Previous studies presented opposite findings, as both older studies reported an increased humeral version angle[10,11], while more recent studies reported a decrease in humeral retroversion[9,12]. retroversion angle, based on the axial rotation of the humeral head in an axial transverse plane, is measured as the angle between the axes of the humeral diaphysis and the humeral … Scapular resting position and gleno-humeral movement dysfunction in asymptomatic racquet players: a case-control study 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). Correlation analyses were also performed in the values of version between dominant and nondominant shoulders and between humeral head version and glenoid version. The average angle for humeral head retroversion was 33 degrees on the dominant side and 29 degrees for the nondominant side. Is global humeral head offset related to intramedullary canal width? Furthermore, the ratio of the SSc and IS muscle (SSc/IS) was calculated to compare muscle balance between both sides and correlate these with the ΔRV-angle. 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[16]. 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. Published by Baishideng Publishing Group Inc. All rights reserved. These bony deformities have been thought to be a consequence of abnormal muscular development[6-8]. Age was again not correlated with a decrease in humeral retroversion (r = -0.120, P = 0.492). The difference in retroversion was correlated with the ratio of muscle sizes. Our results show that altered humeral development can occur very early in life in a population where internal rotation contractures are apparent. Both measurement methods yielded comparable results in the uninvolved shoulder. More external rotation means there is more range for the shoulder to generate energy and therefore greater velocity. 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 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). Bilateral magnetic resonance imaging (MRI) scans of 35 infants (age range: 2-7 mo old) with BPBI were retrospectively analyzed. 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. The most common sequel and focus of surgical intervention in children with BPBI is an internal rotation contracture at the shoulder. 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. 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 … This study found differences in humeral head version and glenoid version by sex and shoulder dominance in a large sample. 2017 Jul;26(7):1128-1136. doi: 10.1016/j.jse.2017.01.027. These surgical interventions all aim for better function through an improved position of the hand in space. Bouacida S, Gauci MO, Coulet B, Lazerges C, Cyteval C, Boileau P, Chammas M. J Shoulder Elbow Surg. The difference in retroversion was correlated with the ratio of muscle-sizes and passive external rotation measurements. Keywords: During sedation, they were monitored by electrocardiograph, measurement of oxygen saturation, and by video. The existing common treatment options all strive for better function of the upper extremity through an improved position of the hand in space. Mean RV-angles were 0.8° vs 27.7° (P < 0.001). 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. Two investigators performed the humeral version measurements. 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. J Bone Joint Surg Am. When treatment becomes warranted and contralateral humeral version measurements greatly differ, a humeral derotational osteotomy may offer the best improvement regarding the hand position. The TIFF files were imported into Geometer’s Sketchpad version 5.03 (KCP Technologies, Emeryville, CA, United States) for further retroversion analyses. • Little Leaguer’s shoulder, which is rotational stress fracture of the proximal humeral epiphyseal plate, may change humeral retroversion. 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]. Altered humeral retroversion warrants attention as a structural change in any child being evaluated for the treatment of an internal rotation contracture. In this retrospective observational study, we included 37 Magnetic resonance imaging (MRI) -scans from a consecutive series of infants (< 1 year old) with a unilateral BPBI. Of further note, the earliest reports by Scaglietti[11] and van der Sluijs et al[10] found an increase in retroversion. Humeral head retroversion is not well described with the literature controversial regarding accuracy of measurement methods and ranges of normal values. Figure 3 shows the distribution of measurements. With greater retroversion of the humerus, there is the potential for more external rotation. The morphologic features and clinical significance of version of the humeral head and glenoid remain unclear. Methods: 2016 Mar;25(3):493-501. doi: 10.1016/j.jse.2015.08.003. Glenoid reconstruction can be challenging, especially if wear has caused changes in the glenoid morphology. Furthermore, the muscle ratio (SSc/IS) on the involved side was significantly smaller compared to the uninvolved side (P = 0.007). 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). This study was IRB approved.  |  Average glenoid retroversion was 1° ± 3°, ranging from -9° to 13°. eCollection 2020. 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). © 2004-2021 Baishideng Publishing Group Inc. All rights reserved. So the humerus must be retroverted 15 degrees. The HCL represents the perpendicular projection from the margins of the articular surface. Twenty-two patients had traumatic anterior shoulder dislocations and another 12 patients had … 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. This is supported by the lack of significant correlation found between age and decreased retroversion on the involved side in both studies. Clin Anat. Therefore, we chose to utilize methods often used in our clinic setting and shown in a prior publication[12]. Anatomical shoulder arthroplasty for osteoarthritis has shown consistent and good results in shoulder with a rotator cuff-intact glenohumeral joint. Passive external rotation was measured with the arm in the adducted position and the elbow by the side. The first proximal reference axis was chosen to provide continuity with earlier retroversion analysis performed in this specific patient group[10,11]. 2020 Feb 10;2020:5736136. doi: 10.1155/2020/5736136. provides blood supply to humeral head; vessel runs parallel to lateral aspect of tendon of long head of biceps in the bicipital groove. J Shoulder Elbow Surg. the lateral humeral offset to optimize the moment arm of the deltoid muscle and the rotator cuff. Manuscript source: Unsolicited manuscript, P- Reviewer: Emara KM, Wyatt MC S- Editor: Dou Y L- Editor: Filipodia E- Editor: Bian YN, BPG is committed to discovery and dissemination of knowledge, Dec 18, 2018 (publication date) through Jan 22, 2021, Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA, Humeral retroversion and shoulder muscle changes in infants with internal rotation contractures following brachial plexus birth palsy, Fabian van de Bunt, Michael L Pearl, Tom van Essen, Johannes A van der Sluijs, Academic Content and Language Evaluation of This Article, CrossCheck and Google Search of This Article. Measurement technique Aug 30. van de Bunt F, Pearl ML, van der JA. Retroversion has a high likelihood of being decreased side in both studies lateral humeral offset to the. As measured by both observers analyzed using the closed region-of-interest polygon tool in Osirix ( Pixmeo ) of retroversion! 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