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

Yıl 2015, Cilt: 49 Sayı: 2, 184 - 189, 22.05.2015
https://doi.org/10.3944/AOTT.2015.14.0188

Öz

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.

Kaynakça

  • Ekholm R, Adami J, Tidermark J, Hansson K, Törnkvist H, Ponzer S. Fractures of the shaft of the humerus. An epidemiological study of 401 fractures. J Bone Joint Surg Br 2006;88:1469–73.
  • Christensen S. Humeral shaft fractures, operative and con- servative treatment. Acta Chir Scand 1967;133:455–60.
  • Kristiansen B, Angermann P, Larsen TK. Functional re- sults following fractures of the proximal humerus. A con- trolled clinical study comparing two periods of immobili- zation. Arch Orthop Trauma Surg 1989;108:339–41.
  • Chen F, Wang Z, Bhattacharyya T. Outcomes of nails ver- sus plates for humeral shaft fractures: a Medicare cohort study. J Orthop Trauma 2013;27:68–72.
  • Crolla RM, de Vries LS, Clevers GJ. Locked intramedul- lary nailing of humeral fractures. Injury 1993;24:403–6.
  • Rommens PM, Verbruggen J, Broos PL. Retrograde locked nailing of humeral shaft fractures. A review of 39 patients. J Bone Joint Surg Br 1995;77:84–9.
  • Ingman AM, Waters DA. Locked intramedullary nailing of humeral shaft fractures. Implant design, surgical technique, and clinical results. J Bone Joint Surg Br 1994;76:23–9.
  • Kummer FJ, Perkins R, Zuckerman JD. The use of the bi- cipital groove for alignment of the humeral stem in shoul- der arthroplasty. J Shoulder Elbow Surg 1998;7:144–6.
  • Balg F, Boulianne M, Boileau P. Bicipital groove orienta- tion: considerations for the retroversion of a prosthesis in fractures of the proximal humerus. J Shoulder Elbow Surg 2006;15:195–8.
  • Rommens PM, Blum J, Runkel M. Retrograde nail- ing of humeral shaft fractures. Clin Orthop Relat Res 1998;350:26–39.
  • Lin J, Hou SM. Rotational alignment of humerus after closed locked nailing. J Trauma 2000;49:854–9.
  • Symeonides PP, Hatzokos I, Christoforides J, Pournaras J. Humeral head torsion in recurrent anterior dislocation of the shoulder. J Bone Joint Surg Br 1995;77:687–90.
  • Kronberg M, Broström LA. Humeral head retroversion in patients with unstable humeroscapular joints. Clin Orthop Relat Res 1990;260:207–11.
  • Li Y, Wang C, Wang M, Huang L, Huang Q. Postoperative malrotation of humeral shaft fracture after plating com- pared with intramedullary nailing. J Shoulder Elbow Surg 2011;20:947–54.
  • Boileau P, Walch G. The three-dimensional geometry of the proximal humerus. Implications for surgical technique and prosthetic design. J Bone Joint Surg Br 1997;79:857– 65.
  • Doyle AJ, Burks RT. Comparison of humeral head retro- version with the humeral axis/biceps groove relationship: a study in live subjects and cadavers. J Shoulder Elbow Surg 1998;7:453–7.
  • Hempfing A, Leunig M, Ballmer FT, Hertel R. Surgi- cal landmarks to determine humeral head retrotorsion for hemiarthroplasty in fractures. J Shoulder Elbow Surg 2001;10:460–3.
  • Park SJ, Kim E, Jeong HJ, Lee J, Park S. Prediction of the rotational state of the humerus by comparing the contour of the contralateral bicipital groove: Method for intraop- erative evaluation. Indian J Orthop 2012;46:675–9.
  • Edelson G. Variations in the retroversion of the humeral head. J Shoulder Elbow Surg 1999;8:142–5.
  • Shinkai RS, Canabarro Sde A, Schmidt CB, Sartori EA. Reliability of a digital image method for measuring medial
  • mandibular flexure in dentate subjects. J Appl Oral Sci 2004;12:358–62.

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

Yıl 2015, Cilt: 49 Sayı: 2, 184 - 189, 22.05.2015
https://doi.org/10.3944/AOTT.2015.14.0188

Öz

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.

 

Kaynakça

  • Ekholm R, Adami J, Tidermark J, Hansson K, Törnkvist H, Ponzer S. Fractures of the shaft of the humerus. An epidemiological study of 401 fractures. J Bone Joint Surg Br 2006;88:1469–73.
  • Christensen S. Humeral shaft fractures, operative and con- servative treatment. Acta Chir Scand 1967;133:455–60.
  • Kristiansen B, Angermann P, Larsen TK. Functional re- sults following fractures of the proximal humerus. A con- trolled clinical study comparing two periods of immobili- zation. Arch Orthop Trauma Surg 1989;108:339–41.
  • Chen F, Wang Z, Bhattacharyya T. Outcomes of nails ver- sus plates for humeral shaft fractures: a Medicare cohort study. J Orthop Trauma 2013;27:68–72.
  • Crolla RM, de Vries LS, Clevers GJ. Locked intramedul- lary nailing of humeral fractures. Injury 1993;24:403–6.
  • Rommens PM, Verbruggen J, Broos PL. Retrograde locked nailing of humeral shaft fractures. A review of 39 patients. J Bone Joint Surg Br 1995;77:84–9.
  • Ingman AM, Waters DA. Locked intramedullary nailing of humeral shaft fractures. Implant design, surgical technique, and clinical results. J Bone Joint Surg Br 1994;76:23–9.
  • Kummer FJ, Perkins R, Zuckerman JD. The use of the bi- cipital groove for alignment of the humeral stem in shoul- der arthroplasty. J Shoulder Elbow Surg 1998;7:144–6.
  • Balg F, Boulianne M, Boileau P. Bicipital groove orienta- tion: considerations for the retroversion of a prosthesis in fractures of the proximal humerus. J Shoulder Elbow Surg 2006;15:195–8.
  • Rommens PM, Blum J, Runkel M. Retrograde nail- ing of humeral shaft fractures. Clin Orthop Relat Res 1998;350:26–39.
  • Lin J, Hou SM. Rotational alignment of humerus after closed locked nailing. J Trauma 2000;49:854–9.
  • Symeonides PP, Hatzokos I, Christoforides J, Pournaras J. Humeral head torsion in recurrent anterior dislocation of the shoulder. J Bone Joint Surg Br 1995;77:687–90.
  • Kronberg M, Broström LA. Humeral head retroversion in patients with unstable humeroscapular joints. Clin Orthop Relat Res 1990;260:207–11.
  • Li Y, Wang C, Wang M, Huang L, Huang Q. Postoperative malrotation of humeral shaft fracture after plating com- pared with intramedullary nailing. J Shoulder Elbow Surg 2011;20:947–54.
  • Boileau P, Walch G. The three-dimensional geometry of the proximal humerus. Implications for surgical technique and prosthetic design. J Bone Joint Surg Br 1997;79:857– 65.
  • Doyle AJ, Burks RT. Comparison of humeral head retro- version with the humeral axis/biceps groove relationship: a study in live subjects and cadavers. J Shoulder Elbow Surg 1998;7:453–7.
  • Hempfing A, Leunig M, Ballmer FT, Hertel R. Surgi- cal landmarks to determine humeral head retrotorsion for hemiarthroplasty in fractures. J Shoulder Elbow Surg 2001;10:460–3.
  • Park SJ, Kim E, Jeong HJ, Lee J, Park S. Prediction of the rotational state of the humerus by comparing the contour of the contralateral bicipital groove: Method for intraop- erative evaluation. Indian J Orthop 2012;46:675–9.
  • Edelson G. Variations in the retroversion of the humeral head. J Shoulder Elbow Surg 1999;8:142–5.
  • Shinkai RS, Canabarro Sde A, Schmidt CB, Sartori EA. Reliability of a digital image method for measuring medial
  • mandibular flexure in dentate subjects. J Appl Oral Sci 2004;12:358–62.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Deneysel Çalışma
Yazarlar

Gokhan Meric Bu kişi benim

Gulsah Zeybek Bu kişi benim

Amac Kiray Bu kişi benim

Aziz Atik Bu kişi benim

Aydin Budeyri Bu kişi benim

Can Kosay Bu kişi benim

Yayımlanma Tarihi 22 Mayıs 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 49 Sayı: 2

Kaynak Göster

APA Meric, G., Zeybek, G., Kiray, A., Atik, A., vd. (2015). Utilization of the bicipital groove axis for confirming alignment of the humerus with transepicondylar and ulnar shaft axes during intramedullary nailing. Acta Orthopaedica Et Traumatologica Turcica, 49(2), 184-189. https://doi.org/10.3944/AOTT.2015.14.0188
AMA Meric G, Zeybek G, Kiray A, Atik A, Budeyri A, Kosay C. Utilization of the bicipital groove axis for confirming alignment of the humerus with transepicondylar and ulnar shaft axes during intramedullary nailing. Acta Orthopaedica et Traumatologica Turcica. Mayıs 2015;49(2):184-189. doi:10.3944/AOTT.2015.14.0188
Chicago Meric, Gokhan, Gulsah Zeybek, Amac Kiray, Aziz Atik, Aydin Budeyri, ve Can Kosay. “Utilization of the Bicipital Groove Axis for Confirming Alignment of the Humerus With Transepicondylar and Ulnar Shaft Axes During Intramedullary Nailing”. Acta Orthopaedica Et Traumatologica Turcica 49, sy. 2 (Mayıs 2015): 184-89. https://doi.org/10.3944/AOTT.2015.14.0188.
EndNote Meric G, Zeybek G, Kiray A, Atik A, Budeyri A, Kosay C (01 Mayıs 2015) Utilization of the bicipital groove axis for confirming alignment of the humerus with transepicondylar and ulnar shaft axes during intramedullary nailing. Acta Orthopaedica et Traumatologica Turcica 49 2 184–189.
IEEE G. Meric, G. Zeybek, A. Kiray, A. Atik, A. Budeyri, ve C. Kosay, “Utilization of the bicipital groove axis for confirming alignment of the humerus with transepicondylar and ulnar shaft axes during intramedullary nailing”, Acta Orthopaedica et Traumatologica Turcica, c. 49, sy. 2, ss. 184–189, 2015, doi: 10.3944/AOTT.2015.14.0188.
ISNAD Meric, Gokhan vd. “Utilization of the Bicipital Groove Axis for Confirming Alignment of the Humerus With Transepicondylar and Ulnar Shaft Axes During Intramedullary Nailing”. Acta Orthopaedica et Traumatologica Turcica 49/2 (Mayıs 2015), 184-189. https://doi.org/10.3944/AOTT.2015.14.0188.
JAMA Meric G, Zeybek G, Kiray A, Atik A, Budeyri A, Kosay C. Utilization of the bicipital groove axis for confirming alignment of the humerus with transepicondylar and ulnar shaft axes during intramedullary nailing. Acta Orthopaedica et Traumatologica Turcica. 2015;49:184–189.
MLA Meric, Gokhan vd. “Utilization of the Bicipital Groove Axis for Confirming Alignment of the Humerus With Transepicondylar and Ulnar Shaft Axes During Intramedullary Nailing”. Acta Orthopaedica Et Traumatologica Turcica, c. 49, sy. 2, 2015, ss. 184-9, doi:10.3944/AOTT.2015.14.0188.
Vancouver Meric G, Zeybek G, Kiray A, Atik A, Budeyri A, Kosay C. Utilization of the bicipital groove axis for confirming alignment of the humerus with transepicondylar and ulnar shaft axes during intramedullary nailing. Acta Orthopaedica et Traumatologica Turcica. 2015;49(2):184-9.