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Majed A, Thangarajah T, Southgate D, et al. Cortical thickness analysis of the proximal humerus. Shoulder Elbow. 2017;11(2):87-93doi: 10.1177/1758573217736744.
Majed, A., Thangarajah, T., Southgate, D., Reilly, P., Bull, A., & Emery, R. (2019). Cortical thickness analysis of the proximal humerus. Shoulder & elbow, 11(2), 87-93. https://doi.org/10.1177/1758573217736744
Majed, Addie, et al. "Cortical thickness analysis of the proximal humerus." Shoulder & elbow vol. 11,2 (2019): 87-93. doi: https://doi.org/10.1177/1758573217736744
Majed A, Thangarajah T, Southgate D, Reilly P, Bull A, Emery R. Cortical thickness analysis of the proximal humerus. Shoulder Elbow. 2019 Apr;11(2):87-93. doi: 10.1177/1758573217736744. Epub 2017 Nov 05. PMID: 30936946; PMCID: PMC6434956.
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Shoulder Elbow. 2019 Apr;11(2):87-93. doi: 10.1177/1758573217736744. Epub 2017 Nov 05.

Cortical thickness analysis of the proximal humerus.

Shoulder & elbow

Addie Majed, Tanujan Thangarajah, Dominic Southgate, Peter Reilly, Anthony Bull, Roger Emery

Affiliations

  1. Division of Surgery and Cancer, Imperial College London, London, UK.
  2. Shoulder and Elbow Service, Royal National Orthopaedic Hospital, London, UK.
  3. Department of Bioengineering, Imperial College London, London, UK.

PMID: 30936946 PMCID: PMC6434956 DOI: 10.1177/1758573217736744

Abstract

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: Thirty-seven proximal humeri were analyzed using novel engineering software to determine cortical thickness in 10 distinct anatomical zones.

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: 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.

Keywords: biomechanical modelling; cortical thickness; fracture patterns; proximal humeral fracture

References

  1. J Shoulder Elbow Surg. 2002 Sep-Oct;11(5):421-7 - PubMed
  2. J Bone Joint Surg Br. 2003 May;85(4):611-7 - PubMed
  3. Clin Orthop Relat Res. 2003 Oct;(415):139-47 - PubMed
  4. Calcif Tissue Int. 2003 Dec;73(6):531-6 - PubMed
  5. J Bone Joint Surg Br. 2004 Apr;86(3):413-25 - PubMed
  6. Calcif Tissue Int. 2004 Aug;75(2):120-2 - PubMed
  7. Arch Orthop Trauma Surg. 2006 Mar;126(2):93-100 - PubMed
  8. J Bone Joint Surg Br. 2006 Oct;88(10):1272-8 - PubMed
  9. J Shoulder Elbow Surg. 2009 May-Jun;18(3):399-407 - PubMed
  10. Calcif Tissue Int. 1990 Oct;47(4):191-3 - PubMed
  11. Invest Radiol. 1990 Jan;25(1):6-18 - PubMed
  12. J Bone Joint Surg Am. 1970 Sep;52(6):1077-89 - PubMed
  13. Bone. 1995 Mar;16(3):375-9 - PubMed
  14. Osteoporos Int. 1993 Mar;3(2):90-6 - PubMed

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