Utilization of the bicipital groove axis for confirming alignment of the humerus with transepicondylar and ulnar shaft axes during intramedullary nailing

Abstract

Objective: Intramedullary nailing is the preferred surgical treatment of humerus shaft fractures. The purpose of this study was to investigate the relationship between the bicipital groove and specific anatomical landmarks in achieving correct alignment of the humerus during intramedullary nailing, and to describe these anatomical landmarks.

Methods: Thirty (15 right; 15 left) total upper cadaver extremities were used in this study. After the anatomical landmarks were identified and marked, humeral head axis, transepicondylar axis, ulnar shaft axis, bicipital groove axis, and angular measurements of these were obtained.

Results: The mean angle between the bicipital groove axis and transepicondylar axis was 48.17°±12.35º (range: 20.10º to 74.6º). The mean angle between the bicipital groove axis and ulna diaphysis axis was 41.82º±11.56 º (range: 17.91º to 68.27º). The mean angle between the humeral head axis and bicipital groove axis was 20.53°±3.90º (range: 11.85º to 31.81º). The mean retroversion angle between the humeral head axis and transepicondylar axis was 27.52±11.37º (range: 4.26º to 49.36º). The mean angle between the humeral head axis and ulna diaphysis axis was 61.73º±12.08º (range: 33.97º to 86.37º). The mean torsion angle was 62.58º±11.28 º (range: 40.74º to 85.74º).

Conclusion: Measurement and utilization of the relationship between the bicipital groove, ulnadiaphysis and transepicondylar axes may be used for restoring humeral rotation.

Keywords

• Alignment
• bicipital groove
• humerus
• intramedullar nailing

İntramedüller çivileme esnasında uygun humerus diziliminin sağlanmasında bisipital oluk aksı ile transepikondiler ve ulna şaft aksının kullanımı

Abstract

Amaç: İntramedüller çivileme humerus şaft kırıklarının cerrahi tedavisinde tercih edilen cerrahi tedavi yöntemidir. Bu çalışmanın amacı, humerus intramedüller çivileme esnasında düzgün dizilimin sağlanması amacıyla kullanılabilecek spesifik anatomik noktalar ile bisipital oluk arasındaki ilişkinin araştırılması ve bu anatomik noktaların tanımlanmasıdır.

Çalışma planı: Otuz (15 sağ; 15 sol) tam kadavra üst ekstremitesi bu çalışmada kullanıldı. Tüm anatomik noktalar belirlenip işaretlendikten sonra, humerus başı aksı, transepikondiler aks, uln şaft aksı, bisipital oluk aksı ve bu akslar arasındaki açı ölçüldü.

Bulgular: Bisipital oluk aksı ile ransepikondiler aks arasındaki açı ortalama 48.17° + 12.35º (aralık 20.10º – 74.6º). Bisipital oluk aksı ile ulna şaft aksı arasındaki açı ortalama 41.82º + 11.56 º (aralık 17.91º – 68.27º). Humerus başı aksı ile bisipital oluk aksı arasındaki açı ortalama 20.53° + 3.90º (aralık 11.85º – 31.81º). Humerus başı aksı ile transepikondiler aks arasındaki ortalama retroversiyon açısı 27.52 + 11.37º (aralık 4.26º – 49.36º). Humerus başı aksı ile ulna diafiz aksı arasındaki açı ortalama 61.73 + 12.08º (aralık 33.97º – 86.37º). Ortalama torsiyon açısı 62.58º + 11.28 º (aralık 40.74º – 85.74º).

Çıkarımlar: Bisipital oluk aksı ile ulna diafiz ve transepikondiler aks arasındaki açı ilişkisinin humerus rotasyonunun düzeltilmesinde kullanılabileceğini düşünülmektedir.

 

Keywords

• Bisipital oluk; dizilim; humerus; intramedüller çivileme.

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