Header

UZH-Logo

Maintenance Infos

The posterior ridge of the greater tuberosity of the humerus: a suitable landmark for the posterior approach to the shoulder joint?


Grob, Karl; Monahan, Rebecca Helen; Manestar, Mirjana; Filgueira, Luis; Zdravkovic, Vilijam (2018). The posterior ridge of the greater tuberosity of the humerus: a suitable landmark for the posterior approach to the shoulder joint? Journal of Shoulder and Elbow Surgery, 27(4):635-640.

Abstract

BACKGROUND: The purpose of this study was to evaluate the posterior ridge of the greater tuberosity, a palpable prominence during surgery, as a landmark for the posterior approach to the glenohumeral joint.
METHODS: Twenty-five human cadaveric shoulders were dissected. In 5 cases, a full-thickness rotator cuff tear was present. The posterior surgical anatomy was defined, and the distance from the ridge to the interval between the infraspinatus (IS) and teres minor (TM) muscle, the distance from the ridge to the inferior border of the glenoid (IBG), and the distance between the IS-TM interval and the IBG were determined.
RESULTS: In all specimens, a prominent ridge on the posterior greater tuberosity lateral to the articular margin could be identified. The IS-TM interval was located, on average, 3 mm proximal to this ridge. The IS-TM interval corresponded to a point 5 mm proximal to the IBG. In all shoulders, the ridge was located, on average, 8 mm proximal to the IBG. The plane of the IS-TM interval showed a vertically oblique direction.
CONCLUSION: The posterior ridge of the greater tuberosity is a suitable landmark to locate the internervous plane between the IS and TM and should not be crossed distally. Unlike other landmarks, the ridge moves with the humeral head, making it is less dependent on the patient's size, sex, and arm position and the quality of the rotator cuff. The ridge is always located proximal to the insertion of the TM and IBG.

Abstract

BACKGROUND: The purpose of this study was to evaluate the posterior ridge of the greater tuberosity, a palpable prominence during surgery, as a landmark for the posterior approach to the glenohumeral joint.
METHODS: Twenty-five human cadaveric shoulders were dissected. In 5 cases, a full-thickness rotator cuff tear was present. The posterior surgical anatomy was defined, and the distance from the ridge to the interval between the infraspinatus (IS) and teres minor (TM) muscle, the distance from the ridge to the inferior border of the glenoid (IBG), and the distance between the IS-TM interval and the IBG were determined.
RESULTS: In all specimens, a prominent ridge on the posterior greater tuberosity lateral to the articular margin could be identified. The IS-TM interval was located, on average, 3 mm proximal to this ridge. The IS-TM interval corresponded to a point 5 mm proximal to the IBG. In all shoulders, the ridge was located, on average, 8 mm proximal to the IBG. The plane of the IS-TM interval showed a vertically oblique direction.
CONCLUSION: The posterior ridge of the greater tuberosity is a suitable landmark to locate the internervous plane between the IS and TM and should not be crossed distally. Unlike other landmarks, the ridge moves with the humeral head, making it is less dependent on the patient's size, sex, and arm position and the quality of the rotator cuff. The ridge is always located proximal to the insertion of the TM and IBG.

Statistics

Citations

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Anatomy
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Uncontrolled Keywords:Surgery, Orthopedics and Sports Medicine, General Medicine
Language:English
Date:1 April 2018
Deposited On:28 Feb 2019 16:40
Last Modified:28 Feb 2019 16:50
Publisher:Elsevier
ISSN:1058-2746
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.jse.2017.10.034
PubMed ID:29305099

Download

Full text not available from this repository.
View at publisher

Get full-text in a library