Basic science
Morphologic features of humeral head and glenoid version in the normal glenohumeral joint

https://doi.org/10.1016/j.jse.2014.02.020Get rights and content

Background

The morphologic features and clinical significance of version of the humeral head and glenoid remain unclear. The purpose of this study was to evaluate the normal values of humeral head version and glenoid version on computed tomography scans and to clarify their features in the normal glenohumeral joint.

Methods

Images for analysis were computed tomography scans of 410 normal shoulders from healthy volunteers. Values of humeral head and glenoid version were measured. In glenoid version measurement, 3-dimensionally corrected slices were reconstructed to eliminate scapular inclination. Differences in humeral head version and glenoid version were assessed between dominant and nondominant shoulders and between men and women. Correlation analyses were also performed in the values of version between dominant and nondominant shoulders and between humeral head version and glenoid version.

Results

The values of humeral head retroversion were widely distributed from −2° to 60°, with an average of 26° ± 11°. Average glenoid retroversion was 1° ± 3°, ranging from −9° to 13°. Both humeral head retroversion and glenoid retroversion were significantly higher on the dominant side than on the nondominant side and significantly higher in men than in women. Humeral head version and glenoid version values were well correlated with those of the contralateral shoulder. No correlation was found between humeral head version and glenoid version.

Conclusions

This study found differences in humeral head version and glenoid version by sex and shoulder dominance in a large sample. Both the humeral head and glenoid are thought to be more retroverted in high-demand shoulders.

Section snippets

Materials and methods

A total of 207 healthy volunteers ranging from 20 to 40 years of age were prospectively recruited for this study. All volunteers gave their informed consent to participate in this study, and candidates with any past illnesses or injuries in the shoulder girdles were excluded. Two cases were excluded after examination because an asymptomatic bone cyst in the humeral head was found on the CT scans of their right shoulders. Thus, 410 shoulders from 205 volunteers (mean age, 30.6 ± 5.0 years; age

Results

Intrarater reliability of the 2 observers was 0.952 (95% confidence interval [CI], 0.936-0.965) and 0.894 (95% CI, 0.858-0.921) for humeral head version and 0.923 (95% CI, 0.897-0.943) and 0.918 (95% CI, 0.890-0.939) for glenoid version, respectively. Interrater reliability was 0.887 (95% CI, 0.850-0.916) for humeral head version measurement and 0.921 (95% CI, 0.903-0.936) for glenoid version measurement. Intrarater and interrater reliabilities exceeded 0.85 for humeral head version and glenoid

Discussion

For anatomic reconstruction of the glenohumeral joint, it is important to understand normal shoulder morphology. However, the morphologic features of the normal glenohumeral joint have not been sufficiently evaluated. With a large number of samples, the present study revealed side-to-side and sex differences in humeral head version and glenoid version. The dominant sides and men had significantly higher retroversion than the nondominant sides and women. Both the humeral head and glenoid are

Conclusion

With a large number of samples, the present study found differences in humeral head version and glenoid version by sex and shoulder dominance. Both the humeral head and glenoid are thought to be more retroverted in high-demand shoulders.

Disclaimer

The authors, their immediate families, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

References (32)

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This study was approved by the Institutional Review Board of Ito Municipal Hospital (reference study number 2012001).

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