The bicipital groove as a landmark for orientation of the humeral prosthesis in cases of fracture

We studied 45 dry cadaveric humeri to determine whether the bicipital groov e of the humerus can be used as a landmark for a proper, individualized ori entation of a humeral prosthesis, especially in the case of a fracture. We performed 3 computed tomography sections (at a level just below the lower p ortion of the head, at the middle of the humeral head, and at a distance 5 cm below the first section), and we used special software for 3-dimensional image processing. To reproduce the individual posterior version of the hea d, when a humeral prosthesis is implanted for fracture, the lateral fin of the prosthesis should be a mean distance 5.2 +/- 2.6 mm (-1.5 to 10.7 mm) f rom the posterior edge of the bicipital groove. If the lateral Fin of the h umeral prosthesis seats just behind the posterior edge of the bicipital gro ove, a difference of -6.3 degrees to 41.7 degrees from the normal posterior version occurs. A new, simple methodology for an individualized posterior version of a humeral prosthesis in cases of fracture is proposed. We applie d this in 6 consecutive patients with fracture of the humeral head that req uired hemiarthroplasty.