Cortical thickness analysis of the proximal humerus.
biomechanical modelling; cortical thickness
fracture patterns; proximal humeral fracture
Journal
Shoulder & elbow
ISSN: 1758-5732
Titre abrégé: Shoulder Elbow
Pays: United States
ID NLM: 101506589
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
08
03
2017
revised:
24
05
2017
accepted:
21
09
2017
entrez:
3
4
2019
pubmed:
3
4
2019
medline:
3
4
2019
Statut:
ppublish
Résumé
Structural changes within the proximal humerus influence the mechanical properties of the entire bone and predispose to low-energy fractures with complex patterns. The aim of the present study was to measure the cortical thickness in different regions of the proximal humerus. Thirty-seven proximal humeri were analyzed using novel engineering software to determine cortical thickness in 10 distinct anatomical zones. The cortical thickness values ranged from 0.33 mm to 3.5 mm. Fifteen specimens demonstrated a consistent pattern of progressive cortical thinning that increased between the bicipital groove (thickest), the lesser tuberosity and the greater tuberosity (thinnest). Fifteen humeri were characterized by a progressive increase in cortical thickness between the greater tuberosity (thinnest), the bicipital groove and lesser tuberosity (thickest). The diaphysis exhibited the thickest cortical zone in 27 specimens, whereas the articular surface possessed the thinnest cortex in 18 cases. In conclusion, this is the first study to comprehensively assess cortical thickness of the humeral head. Our findings suggest that proximal humeral fractures occur along lines of cortical thinning and are displaced by the hard glenoid bone. The identification of specific areas of thick cortices may improve pre-operative planning and optimize fracture fixation.
Sections du résumé
BACKGROUND
BACKGROUND
Structural changes within the proximal humerus influence the mechanical properties of the entire bone and predispose to low-energy fractures with complex patterns. The aim of the present study was to measure the cortical thickness in different regions of the proximal humerus.
METHODS
METHODS
Thirty-seven proximal humeri were analyzed using novel engineering software to determine cortical thickness in 10 distinct anatomical zones.
RESULTS
RESULTS
The cortical thickness values ranged from 0.33 mm to 3.5 mm. Fifteen specimens demonstrated a consistent pattern of progressive cortical thinning that increased between the bicipital groove (thickest), the lesser tuberosity and the greater tuberosity (thinnest). Fifteen humeri were characterized by a progressive increase in cortical thickness between the greater tuberosity (thinnest), the bicipital groove and lesser tuberosity (thickest). The diaphysis exhibited the thickest cortical zone in 27 specimens, whereas the articular surface possessed the thinnest cortex in 18 cases.
CONCLUSIONS
CONCLUSIONS
In conclusion, this is the first study to comprehensively assess cortical thickness of the humeral head. Our findings suggest that proximal humeral fractures occur along lines of cortical thinning and are displaced by the hard glenoid bone. The identification of specific areas of thick cortices may improve pre-operative planning and optimize fracture fixation.
Identifiants
pubmed: 30936946
doi: 10.1177/1758573217736744
pii: 10.1177_1758573217736744
pmc: PMC6434956
doi:
Types de publication
Journal Article
Langues
eng
Pagination
87-93Références
J Shoulder Elbow Surg. 2002 Sep-Oct;11(5):421-7
pubmed: 12378159
J Bone Joint Surg Br. 2003 May;85(4):611-7
pubmed: 12793573
Clin Orthop Relat Res. 2003 Oct;(415):139-47
pubmed: 14612640
Calcif Tissue Int. 2003 Dec;73(6):531-6
pubmed: 14740644
J Bone Joint Surg Br. 2004 Apr;86(3):413-25
pubmed: 15125131
Calcif Tissue Int. 2004 Aug;75(2):120-2
pubmed: 15185060
Arch Orthop Trauma Surg. 2006 Mar;126(2):93-100
pubmed: 16456662
J Bone Joint Surg Br. 2006 Oct;88(10):1272-8
pubmed: 17012413
J Shoulder Elbow Surg. 2009 May-Jun;18(3):399-407
pubmed: 19208485
Calcif Tissue Int. 1990 Oct;47(4):191-3
pubmed: 2242490
Invest Radiol. 1990 Jan;25(1):6-18
pubmed: 2298552
J Bone Joint Surg Am. 1970 Sep;52(6):1077-89
pubmed: 5455339
Bone. 1995 Mar;16(3):375-9
pubmed: 7786641
Osteoporos Int. 1993 Mar;3(2):90-6
pubmed: 8453196