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The Ewha Medical Journal
Ewha Womans University School of Medicine

Ewha Med J 47(2)

pISSN: 2234-3180, eISSN: 2234-2591

DOI: https://doi.org/10.12771/emj.2024.e25

Orginal Article

The use of the bicipital groove as an intraoperative landmark for proximal humeral rotation during fracture fixation

Hyun-Joo Lee1,*, Sanghyun Joung2, Erica Kholinne3, Suk-Joong Lee4, Jong-Pil Yoon1, Jun Tan5, In-Ho Jeon6
1Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu -, Korea.
2AIRS, Daegu -, Korea.
3Faculty of Medicine, Universitas Trisakti, Gatam Institute, Eka Hospital, Jakarta 10440, Indonesia.
4Department of Orthopaedic Surgery, Department of Orthopedic Surgery, Gyeongsang National University Changwon Hospital, Changwon -, Korea.
5Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu -, China.
6Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul -, Korea.
*Corresponding Author: Hyun-Joo Lee, Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu -, Korea, Republic of. Phone: 82-53-420-5628. E-mail: lidmania@daum.net.

© Copyright 2024 Ewha Womans University School of Medicine. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: Jan 01, 2024; Revised: Jan 31, 2024; Accepted: Feb 05, 2024

Published Online: Apr 30, 2024

Abstract

<strong>Objectives: </strong>This study aimed to quantify the relationship between proximal humeral rotation and the lateral border of the bicipital groove on fluoroscopic imaging. <strong>Methods: </strong>The proximal cut segment of a composite normal humerus with a marker on the lateral border of the bicipital groove was mounted on a customized rotation device. Fluoroscopic images were taken consecutively from −60° to 60° with 5° increments and from −15° to 15° with 1° increments. The index value was calculated as the ratio of the distance between the medial boundary of the proximal humerus and the lateral border of the bicipital groove and that between the medial and lateral boundaries of the proximal humerus. The correlation between the humeral rotation and index value was determined. <strong>Results: </strong>The index value showed a strong positive linear correlation (r = 0.998) (p = 0.000) with position when the humerus was internally rotated over the entire range and when externally rotated within the range from 15° of internal rotation to 15° of external rotation (r = 0.991) (p = 0.000). <strong>Conclusion: </strong>The lateral border of the bicipital groove could serve as a useful intraoperative landmark to evaluate proximal humeral rotation which may improve the outcomes of humeral fracture repair and upper arm arthroplasty.

Keywords: humerus; rotational alignment; sawbone model; bicipital groove; estimation