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Humeral prosthesis height and retroversion
68%
891/1320
Humeral prosthesis offset and retroversion
6%
77/1320
Humeral prosthesis head-neck angle and height
20%
258/1320
Humeral prosthesis stem width and height
4%
47/1320
Humeral prosthesis stem length and retroversion
3%
38/1320
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The height of the prosthesis is best determined by the superior border of the pectoralis major insertion (PMI), which has been shown in several clinical and cadaveric studies to be the most reliable instrument to assess humeral prosthesis height. In addition, the PMI can be used to position the implant in regards to retroversion, as the distance and angle of the PMI to the posterior fin of the implant has been investigated and reported (see second reference below). No evidence exists to differentiate this against using the forearm as a landmark for retroversion, however. The referenced study by Murchavosky et al found that in cadaveric dissection, pectoralis major tendons inserted 5.6 cm distal to the superior aspect of the humeral head. The referenced study by Torrens et al also found that the insertion point was 5.6 cm distal to the superior aspect of the humeral head and very reproducible regarding its relationship to retroversion. The mean distance of the PMI to the posterior fin of the prosthesis was 1.06 cm. The mean angle between the PMI and the posterior fin of the prosthesis was 24.65 degrees. The referenced study by Greiner et al found that clinical results from utilizing this reference in fracture cases improved radiographic and clinical outcomes; they also reported that clinical outcomes primarily depended on tuberosity healing. Figure A shows a shoulder hemiarthroplasty.
3.0
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