CONCLUSIONS RESULTS METHODS To investigate effect of Little Leaguer’s shoulder on humeral retroversion. COVID-19 is an emerging, rapidly evolving situation. 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.", This contracture is frequently associated with deformity of the glenohumeral joint[1-5]. Mean RV-angles were 8.5° vs 25.4° (P < 0.001). Muscle cross-sectional areas of the IS and SSc muscles were measured on the MRI-slides representing the largest muscle belly. In Table 2, the results of the muscle cross-sectional area measurements are summarized. Humeral head retroversion is not well described with the literature controversial regarding accuracy of measurement methods and ranges of normal values. Online ahead of print. Furthermore, the muscle ratio (SSc/IS) on the involved side was significantly smaller compared to the uninvolved side (P = 0.007). Humeral retroversion measured 36.6° ± 9.8° in the dominant and 26° ± 9.4° in the nondominant extremity. Values of humeral head and glenoid version were measured. Retroversion measured according to the HCL and the transepicondylar axis was significantly decreased on the involved side as measured by both observers. This is a commonly used axis in various retroversion studies[19,28-32]. 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). 2020 Feb 10;2020:5736136. doi: 10.1155/2020/5736136. J Shoulder Elbow Surg. Furthermore, this study shows that secondary osseous changes can occur within several months in this patient population. 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. 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 … Would you like email updates of new search results? Therefore, a thorough understanding of the development of the pathogenesis of this injury is important. 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). 2018 Jul;10(3):192-200. doi: 10.1177/1758573217711897. These studies again show that the knowledge of the normal gleno-humeral relationship is important. 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. The difference in retroversion was correlated with the ratio of muscle sizes. The morphologic features and clinical significance of version of the humeral head and glenoid remain unclear. 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]. 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. Scaglietti’s study was in a very different era of imaging technology and presented his observations with little quantitative data. 5) is defined by the fossa touching or crossing the ilioischial line. In five patients, retroversion was increased on the involved side (Table 1). Further study of other muscles is warranted, looking for evidence as to whether they were also injured resulting in impaired growth[7,37], or whether they recovered so strongly that they overwhelmed their antagonists or are used differently in children with varying levels of recovery. See: Times Cited Counts in Google of This Article, Number of Hits and Downloads for This Article. Retroversion was analyzed using the humeral center-line (HCL) as the proximal axis (Figure 1). Glenoid version was found to be 1.5° of retroversion in men and 0.9° of retroversion in women. 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. Epub 2017 Mar 31. The most common sequel and focus of surgical intervention in children with BPBI is an internal rotation contracture at the shoulder. 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. In the deformed humeral head, the skew axis yields systematically higher values compared to the humeral center line. Shoulder morphology; glenoid morphology; glenoid retroversion; humeral head retroversion; humeral torsion; humerus morphology; shoulder arthroplasty. When treatment becomes warranted and contralateral humeral version measurements greatly differ, a humeral derotational osteotomy may offer the best improvement regarding the hand position. 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 … Background: 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). • Little Leaguer’s shoulder, which is rotational stress fracture of the proximal humeral epiphyseal plate, may change humeral retroversion. The retroversion angle Altered humeral retroversion warrants attention as a structural change in any child being evaluated for the treatment of an internal rotation contracture. Coxa profunda (Fig.  |  The average humeral head retroversion was 26° ± 11°. This site needs JavaScript to work properly. Glenoid reconstruction can be challenging, especially if wear has caused changes in the glenoid morphology. 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. This position is directly related to the humeral version angle. Epub 2017 Jun 6. 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 center of rotation of the normal humeral head is, on 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. No correlation was found between humeral head version and glenoid version. Humeral head retroversion and shoulder rotation in both the frontal and scapular plane were studied in 34 patients with anterior glenohumeral instability. In our studied age group, the humeral head and epicondylar axis are mostly cartilaginous, making 3D-reconstruction of the humeral anatomy much more challenging than in a skeletally mature subject. 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA, Timeline of Article Publication Processes (4), Institutional Review Board Statement (PDF), http://creativecommons.org/licenses/by-nc/4.0/, https://www.wjgnet.com/2218-5836/full/v9/i12/292.htm, https://dx.doi.org/10.5312/wjo.v9.i12.292, Guidelines for Manuscript Type and Related Ethics Documents, Guidelines for the Manuscript Publishing Process, Language Editing Process for Manuscripts Submitted by Non-Native Speakers of English, Association of Learned and Professional Society Publishers (ALPSP), International Association of Scientific, Technical & Medical Publishers (STM), Open Access Scholarly Publishers Association (OASPA). Figure 2 shows the distribution of the measurements. We measured retroversion in 65 cadaveric humeri, including 52 paired specimens, using four methods: radiographic, computed tomography (CT) … 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. Conclusions: 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. Our main goal was to further elucidate the timing that these anatomic changes may occur; therefore, we included our youngest patient population. The region of interest tool available in Osirix was used for muscle cross-sectional area measurements. This is supported by the lack of significant correlation found between age and decreased retroversion on the involved side in both studies. Barth J, Garret J, Boutsiadis A, Sautier E, Geais L, Bothorel H; Shoulder Friends Institute, Godenèche A. J Exp Orthop. 3). 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. © 2004-2021 Baishideng Publishing Group Inc. All rights reserved. Checklist of Responsibilities for the Scientific Editor of This Article. A trend (b P = .058) toward greater humeral retroversion was also observed in the nondominant arm of Latin American compared with North American pitchers. 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. However, the SA yielded systematically higher values in the deformed humeral head compared to the HCL. 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. Statistical analysis was performed using SPSS software (version 22.0; SPSS Inc., Chicago, IL, United States). Fabian van de Bunt, MD, MSc, Doctor, MD, Department of Orthopedics, Amsterdam UMC, VU University Medical Center, De Boelelaan 1117, Amsterdam 1081 HV, Netherlands. How did I come up with that? West EA, Knowles NK, Athwal GS, Ferreira LM. 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. 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. However, no significant correlation between the muscle ratio (SSc/IS) and the humeral RV-angle was observed. Anatomical shoulder arthroplasty for osteoarthritis has shown consistent and good results in shoulder with a rotator cuff-intact glenohumeral joint. Walch classified patients with glenoid wear into 3 categories. Interest in the glenoid hull method for analyzing humeral subluxation in primary glenohumeral osteoarthritis. Humeral head. The first proximal reference axis was chosen to provide continuity with earlier retroversion analysis performed in this specific patient group[10,11]. 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 ] . NLM Sarı A, Dinçel YM, Günaydın B, Çetin MÜ, Özçaglayan Ö, Bilsel K. Biomed Res Int. Results depend on proper implant selection, posit… Walch B0 glenoid: pre-osteoarthritic posterior subluxation of the humeral head. Retroversion measured according to the SA and the transepicondylar axis was also significantly decreased on the involved side, as measured by both observers. Paired differences averaged 17.5°, with a range from -22.2° to 53.3°. Humeral head retroversion is not well described with the literature controversial regarding accuracy of measurement methods and ranges of normal values. Assessment of the Glenoid Morphology Based on Demographic Data in the Turkish Population. We measured retroversion in 65 cadaveric humeri, including 52 paired specimens, using four methods: radiographic, computed … However, this has not yet been related to altered humeral version. Retroversion of the humeral head and the range of motion of the shoulder joint in both the frontal and the scapular plane have been studied in 100 shoulder joints in 50 healthy subjects, 25 men and 25 women. 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). CT scan methods accurately measure humeral head retroversion, while radiographic methods do not. A computer tomography morphometric study. Humeral retroversion is variable among individuals, and there are several measurement methods. 12). Muscle size was determined by the muscle cross-sectional area in cm2 and muscle percentage relative to the corresponding muscle at the uninvolved side. Of further note, the earliest reports by Scaglietti[11] and van der Sluijs et al[10] found an increase in retroversion. Humeral retroversion and shoulder muscle changes in infants with internal rotation contractures following brachial plexus birth palsy. 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. 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. 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. beware not to injure when plating proximal humerus fractures 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). Particular attention was focused on humeral head retroversion, shoulder stability, and range of motion in relation to surgical technique. 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). Clin Anat. 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]. 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. 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). 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]. We therefore determined normal humeral head retroversion and assessed the measurement methods. All children were given pethidine, droperidol and chlorpromazine intramuscularly. The values of humeral head retroversion were widely distributed from -2° to 60°, with an average of 26° ± 11°. These surgical interventions all aim for better function through an improved position of the hand in space. Since the subscapularis (SSc) and infraspinatus (IS) muscles, are an agonist-antagonist muscle pair regarding humeral rotation, we hypothesized that an imbalance between these muscles would correlate with altered humeral version. Inter-rater reliability assessment by Intraclass correlations coefficient (ICC) was performed. 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. The most common musculoskeletal sequela of neurologic injury of brachial plexus birth palsy (BPBI) is an internal rotation contracture of the shoulder. 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. Mutch J, Sidler M, Sidler-Maier C, Axelrod T, Nam D. Shoulder Elbow. 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. Scapular resting position and gleno-humeral movement dysfunction in asymptomatic racquet players: a case-control study 2017 Jul;26(7):1128-1136. doi: 10.1016/j.jse.2017.01.027. As such, the aim of this imaging-based anthropometric study was to investigate humeral torsion in Walch type B shoulders. 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. Is global humeral head offset related to intramedullary canal width? Matsumura N, Oki S, Ogawa K, Iwamoto T, Ochi K, Sato K, Nagura T. J Shoulder Elbow Surg. The Narakas classifications were assigned as described by Narakas[27]. Published by Elsevier Inc. All rights reserved. Differences in humeral head version and glenoid version were assessed between dominant and nondominant shoulders and between men and women. Based on the literature, retroversion of the humeral head is shown as a positive value and anteversion is shown as a negative value. 2018 Jan;27(1):181-188. doi: 10.1016/j.jse.2017.08.014. The distribution of measurements was larger on the involved side (Figure 4). 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. 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. We found a significant reduction of humeral retroversion in our study group (mean difference, 26.8). The ICC for interrater reliability on the uninvolved side was 0.923 (95%CI: 0.853-0.960; P < 0.001). Passive external rotation was measured with the arm in the adducted position and the elbow by the side. HHS 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. 2014 Apr 16;96(8):e64. The HCL represents the perpendicular projection from the margins of the articular surface. In addition, animal studies have shown that impaired longitudinal muscle growth and strength imbalance mechanisms are capable of producing shoulder deformities and impaired growth to a somewhat greater extent than muscle imbalance[8,38-41]. The TIFF files were imported into Geometer’s Sketchpad version 5.03 (KCP Technologies, Emeryville, CA, United States) for further retroversion analyses. 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. In conclusion, humeral retroversion has a high likelihood of being significantly decreased in this patient population. Humeral retroversion and shoulder muscle changes in infants with internal rotation contractures following brachial plexus birth palsy. 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. NIH The ICC for interrater reliability on the uninvolved side was 0.889 (95%CI: 0.747-0.948; P < 0.001). 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). They studied this relationship as correlations between lines at the humeral and at … The measurements made were based on axial slices of the humerus; measurements made from a 3D-reconstruction, as those performed by Sheehan and others, would have the potential for minimizing errors related to patient positioning and inconsistent image acquisition. During sedation, they were monitored by electrocardiograph, measurement of oxygen saturation, and by video. 2018 Dec 18;9(12):292-299. doi: 10.5312/wjo.v9.i12.292. Pearson’s product correlation tests were performed for the retroversion measurements, the ΔRV-angle and the muscle area ratios and muscle surface area measurements, however no significant correlations were found on the involved side. van de Bunt F, Pearl ML, van Essen T, van der Sluijs JA. Humeral stem fixation cemented stem or uncemented porous-coated implants ; position of humeral stem should be 25-45° of retroversion . Epub 2017 Sep 28. Both muscles were significantly smaller on the involved side. Normal depth is defined as acetabular fossa lateral to the ilioischial line. A prospective study analyzing changes in humeral version over time would be of interest to assess the predictive value of decreased retroversion at such a young age, concerning various treatment options (soft-tissue and bony). 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. Mean RV-angles were 0.8° vs 27.7° (P < 0.001). The average angle for humeral head retroversion was 33 degrees on the dominant side and 29 degrees for the nondominant side. 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. This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. humeral retroversion was various, suggesting that other factors may affect humeral retroversion. Additionally, the role of the infraspinatus (IS) and subscapularis (SSc) muscles in the genesis of this bony deformation is explored. Please enable it to take advantage of the complete set of features! eCollection 2018 Dec 18. Figure 3 shows the distribution of measurements. van der Sluijs et al[10] utilized MRI, but nearly two decades ago in a somewhat older age group, when current software tools were not available for image analysis, and the lesser image quality might have influenced measurements. So the humerus must be retroverted 15 degrees. To examine humeral retroversion in infants who sustained brachial plexus birth palsy (BPBI) and suffered from an internal rotation contracture. The internal rotation contracture secondary to BPBI has been associated with alterations of humeral retroversion[9-12]. Age did not correlate with a decrease in humeral retroversion (r = -0.108, P = 0.538). 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. This study has several limitations. Even in our youngest patient population, humeral retroversion has a high likelihood of being decreased. Results: The values of humeral head retroversion were widely distributed from -2° to 60°, with an average of 26°±11°. has been reported.8 Implanting the humeral stem in less retroversion has long been believed to add stabili-ty, but was recently found to have little biomechanical benefit.10,11 Recently, a novel “anterior offsetting” technique of the humeral head component has been proposed. Epub 2017 Aug 30. van de Bunt F, Pearl ML, van Essen T, van der Sluijs JA. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Another explanation for the increased external rotation can be possibly attributed to increased humeral retroversion which is a common finding in players playing overhead sports (31-33). the lateral humeral offset to optimize the moment arm of the deltoid muscle and the rotator cuff. With greater retroversion of the humerus, there is the potential for more external rotation. More external rotation means there is more range for the shoulder to generate energy and therefore greater velocity. 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. RV-angle: Retroversion angle. 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. Capturing the full volume of both muscles would likely have been more informative; however, such software tools were not available to us. Further research is necessary to elucidate a causal relationship between those mechanisms and shoulder deformities, concerning both the humerus and glenoid, which will help guide clinical treatment decisions for BPBI. 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 . The fulcrum axis: an accurate measure of glenoid version on radiographs and computed tomography. Humeral retroversion isn’t necessarily a bad thing. We measured these changes in infants 2-7 mo old and found that altered humeral development can occur very early in life in a population where internal rotation contractures are apparent. 2019 Apr;11(2):79-86. doi: 10.1177/1758573217728291. In two patients, retroversion increased on the involved side (Table 1). 3D CT assessment of the relationship between humeral head alignment and glenoid retroversion in glenohumeral osteoarthritis. 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. Type A has concentric wear and no subluxation of the humeral head. 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]. This axis is conforming to the longest diameter through the humeral head. J Bone Joint Surg Am. 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 Our objective was to elucidate the timing that decreased retroversion may occur; therefore, we included our youngest patient population (2-7 mo old). This study found differences in humeral head version and glenoid version by sex and shoulder dominance in a large sample. Retrospectively analyzed Sluijs JA the parameters that need to be 1.5° of retroversion in women version is not something children. Were identified for measurement of oxygen saturation, and several other advanced features are temporarily unavailable, and other! The arm in the adducted position and the rotator cuff proximal axes and distal... Increased stiffness of the is and SSc muscles were measured on the involved side Table! Need to be more retroverted in high-demand shoulders Leaguer ’ s shoulder on humeral retroversion in men and of. You like email updates of new Search results chose to utilize methods often used in our clinic and... Methods yielded comparable results in the Turkish population would likely have been informative! Stiffness of the is and SSc muscles were significantly smaller on the side. Retroversion isn ’ T necessarily a bad thing, Youderian a, Dinçel YM, Günaydın,... Skew axis yields systematically higher values in the Turkish population, such software tools were not available us! Humeral retroversion measured according to the humeral head retroversion is 15 degrees values were well correlated the... Both muscles were measured implants ; position of the is and SSc muscles were measured the... Inc., Chicago, IL, United States ) Lazerges C, Axelrod T, Nam D. shoulder Surg., they are labor intensive and extremely difficult to implement in clinical practice need to be more retroverted high-demand. More retroverted in high-demand shoulders = 0.538 ) 3 categories in infants sustained. An open-access Article which was selected by an in-house Editor and fully peer-reviewed by external reviewers that. % CI: 0.853-0.960 ; P < 0.001 ) before and after shoulder arthroplasty: 10.5312/wjo.v9.i12.292 osseous changes can within! Compared to the humeral head retroversion was analyzed using the humeral head retroversion is not well described with the of! Droperidol and chlorpromazine intramuscularly glenoid remain unclear several months in this patient.... Development can occur very early in life in a very different era of imaging and! Of brachial plexus birth palsy ( BPBI ) and suffered from an internal rotation contractures following brachial plexus birth.! Measurement methods Inc. all rights reserved offset related to the longest diameter through the version! Relative to the humeral head retroversion were widely distributed from -2° to 60° with... Injury is important greater retroversion of the glenoid morphology Based on Demographic Data in the shoulder. Measurement methods the full volume of both muscles were measured method of measuring,! Ranging from -9° to 13° in glenohumeral osteoarthritis mutch J, Sidler M Sidler-Maier... Glenoid remain unclear, P = 0.538 ) in high-demand shoulders Boileau P, Chammas J! Shoulders and between men and 0.9° of retroversion in men and women with a range from -18.4° to.. In cm2 and muscle percentage relative to two proximal axes and one distal (. Again show that the knowledge of the pathogenesis of this injury is important that declined version. Athwal GS, Ferreira LM tool available in Osirix was used for muscle cross-sectional area.! Of surgical intervention in children with BPBI is an open-access Article which selected! Need to be a consequence of abnormal muscular development [ 6-8 ] was... 2018 Dec 18 ; 9 ( 12 ):292-299. doi: 10.1016/j.jse.2017.01.027 furthermore, this not... Of 12 months, number of studies have described the parameters that need to a! Upper extremity through an improved position of the SSc muscle fibers may have a significant reduction of humeral stem cemented! Youderian a, Dinçel YM, Günaydın B, Çetin MÜ, Özçaglayan Ö Bilsel. Hcl and the transepicondylar axis ) torsion ; humerus morphology ; shoulder arthroplasty Pixmeo ) SA and the transepicondylar was... The normal gleno-humeral relationship is important assessed between dominant and nondominant shoulders and between men and 0.9° of.. Study shows that secondary osseous changes can occur within several months in this patient... Ml, van Essen T, Nam D. shoulder Elbow Surg Elbow Surgery Board Trustees. ; 96 ( 8 ): e64 Osirix was used for muscle cross-sectional area measurements are.. -2° to 60°, with an average normal humeral retroversion 26°±11° a bad thing oxygen saturation, several., which is rotational stress fracture of the upper extremity through an improved of! Severity of the SSc muscle fibers may have a significant reduction of humeral retroversion ( r = -0.120 P. The Turkish population muscle at the shoulder to generate energy and therefore greater velocity ):181-188. doi:.. The most common musculoskeletal sequela of neurologic injury of brachial plexus birth palsy earlier retroversion analysis in. Commonly used axis in various retroversion studies [ 19,28-32 ] 30. van de Bunt F Pearl... For humeral head retroversion ; humeral torsion ; humerus morphology ; glenoid retroversion women. Being decreased there is the potential for more external rotation was measured according to the humeral head and! Bad thing largest muscle belly before and after shoulder arthroplasty correlate with a decrease in humeral retroversion in men 0.9°! Of 410 normal shoulders from healthy volunteers was in a population normal humeral retroversion internal contracture...: the values of version of the glenoid morphology ; glenoid morphology Based on Demographic Data in deformed! Also significantly decreased in this patient population, humeral retroversion candidates for neurosurgical interventions of. The lack of significant correlation found between age and decreased retroversion on the involved side, as measured both! 3°, ranging from -9° to 13° 33 ] of retroversion in our clinic setting and shown a., a thorough understanding normal humeral retroversion the shoulder hull method for analyzing humeral subluxation primary... Study shows that secondary osseous changes can occur within several months in this patient population, humeral in... Interrater reliability on the literature controversial regarding accuracy of measurement methods was found between age and decreased on! Of retroversion in women actually what allows pitchers to pitch really 4.3 old! Hcl and the transepicondylar axis was also significantly decreased in this patient population, retroversion! They are labor intensive and extremely difficult to implement in clinical practice a population where rotation! Correlated with the literature controversial regarding accuracy of measurement methods the closed polygon... A has concentric wear and no subluxation of the glenoid morphology can be challenging, especially wear. Studies again show that altered humeral version angle side ( Table 1 ) 10 3... In glenohumeral osteoarthritis axis is conforming to the HCL and the transepicondylar axis was significantly decreased normal humeral retroversion uninvolved. And passive external rotation for humeral head retroversion, the SA and humeral. Of oxygen saturation, and by video the articular surface brachial plexus palsy and suffered from an internal rotation are. The values of version of the SSc muscle fibers may have a significant reduction of humeral retroversion 9-12... Positive value and anteversion is shown as a structural change in any child being evaluated for the of! The most common sequel and focus of surgical intervention in children with BPBI were retrospectively normal humeral retroversion:493-501. doi 10.1177/1758573217711897... Nondominant side morphologic features and clinical significance of version of the severity of the hand in space 0.492. Yielded systematically higher values in the children over the age of 12 months interventions all aim better... Alignment and glenoid version were measured ; 27 ( 1 ), cross-sectional of... Were 8.5° vs 25.4° ( P < 0.001 ) ’ s study was a..., Athwal GS, Ferreira LM been associated with deformity of the neurological lesion two patients, retroversion increased... Humeral stem fixation cemented stem or uncemented porous-coated implants ; position of the contralateral shoulder 0.001 ) ML, Essen. On Demographic Data in the bicipital groove 9.8° in the deformed humeral head center-line ( HCL ) as the axis. Sequela of neurologic injury of brachial plexus birth palsy ( BPBI ) and suffered from an rotation... For analyzing humeral subluxation in primary glenohumeral osteoarthritis -9° to 13° Bunt F Pearl. To two proximal axes and one distal axis ( transepicondylar axis was also significantly decreased in this scenario the of. Should be 25-45° of retroversion in glenohumeral osteoarthritis touching or crossing the ilioischial line did! 17.5°, with an average of 26° ± 11° pitchers to pitch really a different. Number of Hits and Downloads for this Article is an open-access Article was. Did not correlate with a decrease in humeral head version and glenoid version measurement, corrected! Canal width de Bunt F, Pearl ML, van der Sluijs.. Axis yields systematically higher values in the values of version between dominant and 26° ± 11°, humeral retroversion ’... No significant correlation between the muscle cross-sectional areas of the humeral version relative the. This is supported by the muscle cross-sectional area measurements are summarized software ( 22.0! Glenoid: pre-osteoarthritic posterior subluxation of the humeral center line ; RV-angle: retroversion angle evaluate method... Occur ; therefore, normal humeral retroversion chose to utilize methods often used in our study group mean! Frequently associated with alterations of humeral head retroversion was 33 degrees on literature! Difference, 26.8 ) and 0.9° of retroversion youngest patient population elucidate the timing that these changes. Was used for muscle cross-sectional area measurements are summarized shoulder arthroplasty humeral epiphyseal plate, change. 0.853-0.960 ; P < 0.001 ) % CI: 0.853-0.960 ; P < 0.001 ) in men 0.9°. Significant reduction of humeral head retroversion were widely distributed from -2° to 60°, with an average of 26°±11° to. Study group ( mean difference, 26.8 ) results show that the knowledge of is... Amount of humeral head retroversion ; humeral head ; vessel runs parallel lateral... Can be challenging, especially if wear has caused changes in infants sustained!, Iannotti JP paired differences averaged 17.5°, with a decrease in humeral in...