Afsana P Hasan1, Joideep Phadnis2, Ruurd L Jaarsma3, Gregory I Bain3. 1. Department of Orthopedics and Trauma, Flinders Medical Centre, Adelaide, SA, Australia; Department of Orthopedics and Trauma, Flinders University, Adelaide, SA, Australia. Electronic address: afsana.hasan@gmail.com. 2. Department of Orthopedics and Trauma, Flinders Medical Centre, Adelaide, SA, Australia; Department of Trauma and Orthopaedics, Brighton and Sussex University Hospitals, Brighton, UK. 3. Department of Orthopedics and Trauma, Flinders Medical Centre, Adelaide, SA, Australia; Department of Orthopedics and Trauma, Flinders University, Adelaide, SA, Australia.
Abstract
BACKGROUND: The aim of this study was to assess proximal humeral fracture patterns using 3-dimensional computed tomography images and relate them to the normal osseous landmarks and soft-tissue attachments. METHODS: Forty-eight 3-dimensional computed tomography scans of proximal humeral fractures were retrospectively collected, and the fractures were transcribed onto proximal humeral templates. We analyzed the common location and orientation of the fracture lines, with a focus on fractures of the articular surface, tuberosities, metaphysis, and proximal diaphysis. These fractures were compared with the attachments of the rotator cuff and glenohumeral capsule. RESULTS: Fifty-two percent of the fractures involved the articular surface. No fractures passed through the bicipital groove, and fractures were more commonly found on the posterior lesser tuberosity and on the anterior greater tuberosity, coinciding with the intervals between the rotator cuff tendon insertions. Intracapsular fractures of the calcar were more common (68%) than extracapsular fractures (32%). On the anterolateral aspect of the proximal humerus, fractures radiated from the articular margin, vertically down through the tuberosity zone between the rotator cuff footprints, meeting horizontally oriented fractures in the metaphyseal zone. On the posterior aspect, vertical fractures from the tuberosity zone continued downward to the metaphyseal zone adjacent to the infraspinatus and teres minor footprints. CONCLUSIONS: Fractures of the proximal humerus follow characteristic patterns. Fractures frequently split the greater tuberosity and are closely related to the intervals of the rotator cuff attachments. Crown
BACKGROUND: The aim of this study was to assess proximal humeral fracture patterns using 3-dimensional computed tomography images and relate them to the normal osseous landmarks and soft-tissue attachments. METHODS: Forty-eight 3-dimensional computed tomography scans of proximal humeral fractures were retrospectively collected, and the fractures were transcribed onto proximal humeral templates. We analyzed the common location and orientation of the fracture lines, with a focus on fractures of the articular surface, tuberosities, metaphysis, and proximal diaphysis. These fractures were compared with the attachments of the rotator cuff and glenohumeral capsule. RESULTS: Fifty-two percent of the fractures involved the articular surface. No fractures passed through the bicipital groove, and fractures were more commonly found on the posterior lesser tuberosity and on the anterior greater tuberosity, coinciding with the intervals between the rotator cuff tendon insertions. Intracapsular fractures of the calcar were more common (68%) than extracapsular fractures (32%). On the anterolateral aspect of the proximal humerus, fractures radiated from the articular margin, vertically down through the tuberosity zone between the rotator cuff footprints, meeting horizontally oriented fractures in the metaphyseal zone. On the posterior aspect, vertical fractures from the tuberosity zone continued downward to the metaphyseal zone adjacent to the infraspinatus and teres minor footprints. CONCLUSIONS:Fractures of the proximal humerus follow characteristic patterns. Fractures frequently split the greater tuberosity and are closely related to the intervals of the rotator cuff attachments. Crown
Authors: Maximilian Lenz; Stephanie Kahmann; Mehdi Behbahani; Lenhard Pennig; Michael Hackl; Tim Leschinger; Lars Peter Müller; Kilian Wegmann Journal: Arch Orthop Trauma Surg Date: 2022-05-17 Impact factor: 3.067
Authors: Hassanin Alkaduhimi; Henk-Jan van der Woude; Lukas P E Verweij; Stein J Janssen; Nienke W Willigenburg; Neal Chen; Michel P J van den Bekerom Journal: JSES Int Date: 2022-01-12