Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Humerus”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed1991

Comparison of humerus length with femur length in fetuses with Down syndrome.

A recent report by FitzSimmons et al. demonstrated a greater frequency of upper- versus lower-extremity shortening in autopsies of second-trimester fetuses with trisomy 21. We undertook this study to determine whether this upper-limb shortening could be detected by prenatal ultrasonography in the second trimester and therefore identify fetuses at risk for trisomy 21. A retrospective review of all prenatal sonograms preceding genetic amniocentesis was conducted. Between 1987 and 1990 11 consecutive fetuses between 15 and 22 weeks' gestation with trisomy 21 were identified by genetic amniocentesis. Femur and humerus lengths were plotted on growth curves created from 1470 normal patients between 12 and 26 weeks. Gestational age was confirmed by last menstrual period and biparietal diameter. In fetuses with trisomy 21, seven of 11 humeri were less than 5th percentile, for a sensitivity of 64%, whereas only two of 11 femurs were less than 5th percentile, for a sensitivity of 18%. Biparietal diameter/femur length and biparietal diameter/humerus length ratios were also tested to predict Down syndrome. In only 2 of 11 cases was the biparietal diameter/femur length ratio greater than 95th percentile, whereas the biparietal diameter/humerus length ratio was greater than 95th percentile in 7 of 11. Since all seven were identified by shortened humerus alone, we conclude that humerus length versus gestational age is the simplest and most effective screen. The positive predictive value of an abnormally short humerus length in detecting Down syndrome was 6.8% in our population where the prevalence of Down syndrome was 1 of 173. The present study supports the observations of FitzSimmons et al. that shortened humerus length has a greater sensitivity than femur length in cases of trisomy 21. We conclude that in fetuses at risk for trisomy 21 humerus length should be determined, because it may, if shortened, aid in the prenatal diagnosis.

Anthropometry↗
PubMed1988

Measurement of humerus and radius bone mineral content in the term and preterm infant.

We compared two anatomic sites for single-photon absorptiometric measurement of bone mineral content (BMC) in term and preterm infants. The distal one third of the radius and the midportion of the humerus were evaluated for measurements of BMC with an unmodified, commercially available bone densitometer. We assessed reproducibility of BMC and bone width (BW) measurements and defined normal at-birth ranges of BMC, BW, and BMC/BW ratio for infants with gestational ages of 24 to 42 weeks. Humerus BMC correlated with gestational age, birth weight, and BW of patients and did not differ from humerus BMC values determined over the same range of gestational ages at another center. Representative serial measurements of two very low birth weight (VLBW) infants are presented to demonstrate the feasibility of using humerus BMC in longitudinal studies to assess changes in bone mineralization. We conclude that bone densitometer measurements of mid-humerus BMC can be successfully performed and are preferable to similar measurements of the radius for VLBW infants. Normal humerus BMC values were defined for use in diagnosis and evaluation of the efficacy of treatment in VLBW infants who are at high risk of developing osteopenia of prematurity.

Bone and Bones↗
PubMedDate not supplied

Sonographic screening for trisomy 21: fetal humerus:foot length ratio, a useful new marker.

We have analyzed morphometric measurements from midgestational fetal necropsies and shown that arm and foot lengths are linear relationships versus gestational age (GA). Using foot length as the GA determinant, we found that the ratio of arm:foot length was also a linear relationship and was decreased in trisomy 21 fetuses when compared to age-matched normals. Based on these laboratory findings, we prospectively evaluated the use of the humerus:foot length ratio as a sonographic screening tool for identification of fetuses at risk for trisomy 21. Humerus length, foot length and the humerus:foot length ratio were found to be linear relationships vs. gestational age in both the normal and trisomy 21 populations. However, the regressions for the humerus:foot length ratio were significantly different between normals and Down's fetuses (p < 0.001). We found that a humerus:foot length ratio < or = 0.85 correctly identified 47% of our trisomy 21 fetuses (spec = 0.92, PPV = 0.25, NPV = 0.97). When compared to women > or = 35 years old in our high risk population, a humerus:foot length ratio < or = 0.85 carried an odds ratio of 52.7 (99% CL = 9.72-285.23) for trisomy 21.

Adult↗
PubMedDate not supplied

Limited effectiveness of femur and humerus shortening as markers of Down syndrome in early midtrimester fetuses.

This is a prospective screening study addressed to assess the value of femur and humerus shortening in the prenatal detection of Down syndrome. Prior to amniocentesis, 1,543 consecutive pregnancies between 13 and 18 weeks were studied. Femur and humerus shortening were assessed with the use of 6 different ratios, and then correlated with the karyotype obtained in amniotic fluid. Sensitivities achieved for Down syndrome with femur ratios were lower than those using humerus (17-22 vs. 43%) for similar false-positive rates (7-8 vs. 6-8%). The most effective ratio was the observed-to-expected humerus length with 43% sensitivity for a 6% false-positive rate. Combining femur and humerus measurements did not substantially improve the prediction obtained using the best humeral ratio. In conclusion, femur and humerus shortening appears to be of limited value in the detection of Down syndrome.

Adult↗
PubMedDate not supplied

Retroversion of the humerus in the throwing shoulder of college baseball pitchers.

BACKGROUND: Increased external rotation and decreased internal rotation have been noted to occur progressively in the throwing shoulder of baseball pitchers. HYPOTHESIS: Proximal remodeling of the humerus contributes to the rotational asymmetry between shoulders in pitchers. STUDY DESIGN: Descriptive anatomic study. METHODS: Both shoulders of 19 male college baseball pitchers were evaluated and retroversion of the humerus calculated by using the technique of Söderlund et al. Measurements were taken of passive glenohumeral external rotation at 0 degrees and 90 degrees of abduction and internal rotation at 90 degrees of abduction under a 3.5-kg load. Subjects completed a questionnaire on the amount and duration of overhead throwing performed during the ages 8 through 16 years. RESULTS: All of the subjects had greater external rotation at 0 degrees and 90 degrees of abduction, decreased internal rotation at 90 degrees of abduction, and greater retroversion of the humerus in their dominant compared with nondominant shoulders. A significant difference was found between dominant and nondominant external rotation at 0 degrees and 90 degrees of abduction, internal rotation at 90 degrees of abduction, and retroversion of the humerus. In the dominant arm, there was a significant correlation between retroversion of the humerus and external rotation at 0 degrees and 90 degrees of abduction. There was also a significant correlation between the side-to-side difference in retroversion of the humerus compared with the side-to-side difference in external rotation at 90 degrees of abduction. CONCLUSIONS: Rotational changes in the throwing shoulder are due to bony as well as soft tissue adaptations.

Adolescent↗
PubMed2005

[External rotation osteotomy of the humerus for the treatment of shoulder problems secondary to obstetric brachial plexus palsy].

OBJECTIVES: We evaluated the results of external rotation osteotomy of the humerus for the treatment of shoulder problems secondary to obstetric brachial plexus palsy. METHODS: Forty children (24 boys, 16 girls; mean age 7.5 years; range 23 months to 14.8 years) underwent external rotation osteotomy of the humerus. Involvement was at the C5-6 roots in 11 patients, C5-6-7 roots in 19 patients, and at all the roots in 10 patients. Twenty-six patients had humeral head deformity and eight patients had posterior subluxation. The shoulder was ankylosed in one patient. Zancolli and Putti signs were positive in six and eight patients, respectively. The mean active shoulder abduction was 80 degrees (range 0 to 170 degrees ) and the mean internal rotation contracture was 27 degrees (range 10 degrees to 50 degrees ). Fourteen patients, all of whom were beyond five years of age, had an abduction contracture. Preoperative and postoperative functional evaluations were made with the use of the Mallet scale. Preoperatively, 35 shoulders had a score of II, five had a score of III. Osteotomies were performed in the proximal humerus in patients older than five years and in the mid-humerus in those without a contracture or younger than five years. RESULTS: The mean postoperative shoulder abduction was 95.7 degrees (range 30 degrees to 170 degrees ). Internal rotation contractures improved in all the patients. Abduction contractures did not resolve in two patients in whom a mid-humeral osteotomy was performed. Postoperative Mallet scores ranged from II to V in five, six, 15, and 14 shoulders, respectively. Rotation provided by the osteotomy was lost in one patient because of a humerus fracture that occurred in a traffic accident. Passive total shoulder rotation remained unchanged following surgery. Patients having better preoperative range of motion and who were at younger ages benefited the most from surgical treatment. CONCLUSION: External rotation osteotomy of the humerus must be performed at early ages before the shoulder gets stiffer.

Adolescent↗
PubMed2006

A comparative biomechanical analysis of implants for the stabilization of proximal humerus fractures.

A new humerus nail (Sirus) has become available for the treatment of fractures of the proximal humerus. The aim of the study was the biomechanical comparison of this implant with established systems. 12 matched pairs of human humeri were employed for testing. Three randomized groups were formed (n = 4 pairs). A bending moment of 7.5 Nm and a torsional moment of 8.3 Nm were applied in a test of five loading cycles to all intact bones. Loading was consistently initiated at the distal epiphysis. The consequent deformation at the distal epiphysis was continuously recorded. Then an osteotomy with a defect of 5 mm was created to simulate an unstable subcapital humerus fracture. For paired comparison, one of each pair was stabilized with the Sirus proximal humerus nail. The other side was fixed with a reference implant. The following groups were created.: Group I: Sirus versus Proximal humerus nail (PHN) with spiral blade. Group II: Sirus versus PHILOS plate. Group III: Sirus versus 4.5 mm AO T-plate. The proximal humerus nail (Sirus) demonstrated significantly higher stiffness values than the reference implants for both bending and torsional load. The following values were recorded at a bending moment of 7.5 Nm: Sirus 14.2 mm, PHN 20.7 mm, PHILOS plate 28.1 mm, 4.5 AO T-plate 29.3 mm p < 0.0012). The values at 8.3 Nm torsional moment were: Sirus 8.5 degrees , PHN 12.3 degrees , PHILOS plate 16.4 degrees , 4.5 AO T-Platte 15.6 degrees (p < 0.002). The intramedullary load carriers were biomechanically superior when compared to the plating systems in the fracture model presented here. Supplementary, the Sirus Nail showed higher stiffness values than the PHN. However, the latter are gaining in importance due to the possibility of minimal invasive implantation. Whether this will be associated with functional advantages requires further clinical investigation.

Biomechanical Phenomena↗
PubMed2004

Increased fragility in patients with fracture of the proximal humerus: a case control study.

The aim of this study was to evaluate whether a fracture of the proximal humerus is associated with an increased prevalence of preceding fractures or a risk of subsequent fractures. All patients who were treated at the Malmö General Hospital in 1987 for a fresh fracture of the proximal humerus were identified, representing practically all fractures of the proximal humerus in Malmö city (250,000) that year. Two hundred fifty-three adult patients, 54 men with an average age of 66 (24-90) and 199 women with a mean age of 74 (22-98) years, were included in the study together with 475 age- and gender-matched control persons. In 1999, fracture prevalence of patients and controls were rated by a survey at the Dept. of Radiology. There was a significantly increased prevalence of previous fractures before 1987 in the humerus fracture group with an odds ratio (OR) of 3.5 [95% confidence interval (95% CI), 2.2-5.5] for a spinal fracture, OR 1.8 (95% CI, 1.3-2.6) for a previous fracture to the upper extremity, and OR 1.8 (95% CI, 1.2-2.6) for a preceding fracture of the lower limb. The proximal humerus fracture also predicted a significantly increased risk of a subsequent fracture. The hazard ratio (HR) was 2.5 (95% CI, 1.7-3.7) for a forthcoming spinal fracture, HR 2.8 (95% CI, 2.0-3.7) for a future fracture of the upper extremity, and HR 2.0 (95% CI, 1.2-3.5) for a lower limb fracture. In a subgroup of male patients, an almost five times increased risk of sustaining subsequent extremity fractures was observed. In summary, a fracture of the proximal humerus is associated both with increased prevalence of previous fractures of the spine and extremities and also predicting an increased risk of future fractures.

Adult↗
PubMed2006

Biomechanical comparison of a unique locking plate versus a standard plate for internal fixation of proximal humerus fractures in a cadaveric model.

BACKGROUND: Newer internal fixation devices with a locking mechanism between the plate and the screw have recently been released. The efficacy of these plates in the proximal humerus has yet to be fully described. There is a need to compare the biomechanical properties of efficacy of plate fixation with or without locking screws for surgery of two-part proximal humerus fractures. Multiple-plane locking plate and cloverleaf plate designs were tested to determine their ability to maintain fixation on the humeral head. METHODS: Eight matched pairs of cadaveric shoulders with 7-millimeter osteotomy defects at the surgical neck simulating two-part fractures of the proximal humerus were loaded to failure in thirty degrees of glenohumeral abduction. One side was repaired with a proximal humerus locking plate and the other with a cloverleaf plate. The rotator cuff musculature was then loaded via a servo-hydraulic testing machine under displacement control to simulate the deforming forces present in vivo. FINDINGS: The average maximum load to failure was greater in proximal humerus locking plates than in cloverleaf plates (876 versus 712; P=0.04). INTERPRETATION: In the cadaveric, two-part proximal humerus fracture model that was created, the locking plate displayed significantly greater holding power of the humeral head. Clinical relevance is unproven but may be manifested in vivo as improved early range of motion exercises and functional outcome.

Aged↗
PubMed2006

Correlation between iatrogenic ulnar nerve injury and angular insertion of the medial pin in supracondylar humerus fractures.

The aim of this study was to assess the correlation between the occurrence of iatrogenic ulnar nerve injury and frontal and saggital angular insertion of the medial pin in type 3 pediatric supracondylar humerus fractures treated by closed reduction and percutaneous fixation using a cross-pin configuration. Radiographs of 90 children were retrospectively reviewed and two radiographic parameters were measured. The frontal humerus-pin angle was formed between the long axis of the humerus shaft and the axis of the medial pin on an anteroposterior radiograph. The saggital humerus-pin angle was formed between the long axis of the humerus shaft and the axis of the medial pin on a lateral radiograph and expressed as positive and negative values if the insertion direction of the pin was anterior to posterior or posterior to anterior, respectively. There was a significant difference between the mean saggital humerus-pin angle values of ulnar nerve injury and no neurological complication groups (12.1 degrees versus 1.6 degrees , respectively; P=0.001). It was concluded that, anteroposterior insertion of the medial pin in the saggital plane, while the elbow was in hyperflexion, correlated with the occurrence of iatrogenic ulnar nerve injury.

Adolescent↗
PubMedDate not supplied

Techniques for direct radiographic visualization during closed pinning of supracondylar humerus fractures in children.

After reduction of a displaced supracondylar humerus fracture, the distal humerus must be easy to visualize; radiographic techniques in which the forearm overlaps the distal humerus make interpretation of fracture reduction difficult. Eighteen patients with displaced supracondylar humerus fractures were treated with reduction that was maintained manually with a variant of Dunlop's extension traction. This allows direct fluoroscopic evaluation of Baumann's angle, the contour of the distal humerus, the pin insertion site, and the angle of pin insertion. In young patients with a thin distal humerus and swollen elbow, the easiest pin placement may be achieved by inserting the pin on the lateral view (after the anteroposterior view confirms a satisfactory reduction).

Child↗
PubMed2002

Bone mineral content and density in the humerus of adult myostatin-deficient mice.

Myostatin (GDF-8), a member of the transforming growth factor-b superfamily of secreted growth and differentiation factors, is a negative regulator of skeletal muscle growth. We investigated the effects of increased muscle mass on bone morphology by examining bone mineral content and density in the humeri of myostatin-deficient mice. We compared the humeri of 11 mixed-gender, adult mice homozygous for the disrupted myostatin sequence with those from 11 mixed-gender, adult wild-type mice. Body mass, deltoid mass, and triceps mass were recorded from each animal and densitometric and geometric parameters were collected from the humerus using peripheral quantitative computed tomography (pQCT). Cross-sectional slices were scanned at four different positions along the humerus corresponding to 15%, 40%, 60%, and 85% of total humerus length. Results show that the myostatin- deficient mice weigh more than controls and have significantly larger triceps and deltoid muscles. The myostatin-deficient animals also have significantly (P < 0.05) higher trabecular area and trabecular bone mineral content (BMC) in the proximal humerus (15% length) and significantly (P < 0.01) higher cortical BMC, cortical area, and periosteal circumference in the region of the deltoid crest (40% length). The myostatin knockouts otherwise do not differ from controls in cortical BMC. Moreover, experimental and control mice do not differ significantly from one another in cortical bone mineral density (BMD) at any of the sites examined. These results suggest that the effects of increased muscle mass on the mouse humerus are localized to regions where muscles attach; furthermore, these effects include increased mineral content of both trabecular and cortical bone.

Animals↗
PubMed2006

Assessment of bone quality in the proximal humerus by measurement of the contralateral site: a cadaveric analyze.

INTRODUCTION: The presence of osteoporosis decreases the success of osteosynthesis, especially in the proximal humerus. Estimation of the bone mineral density (BMD) at the fracture site could aid in the decision making for surgical treatment and potential implant choice with regard to the individual bone properties. BMD measurement at a fracture site is prone to inaccuracies and alternative measurement sites need to be identified. In the case of a proximal humerus fracture, promising alternative measurement sites are at the same contralateral or at a different ipsilateral location. The aim of this study was to determine if the BMD for the humeral head can be predicted by BMD measurements from the ipsilateral distal humerus or the contralateral proximal humerus. MATERIAL AND METHODS: Cancellous BMD values were obtained from 88 paired human cadaver humeri (age 75.8+/-13.5 years) at the humeral head and at the distal metaphyseal area by pQCT. Correlations between BMD values of the ipsi- and contralateral sites were computed. RESULTS: Correlations between proximal and distal BMD values within one bone were moderate for both left (R2=0.37) and right humeri (R2=0.40). BMD comparison between left and right humeri revealed high correlations for both the distal (R2=0.90) and the proximal humerus (R2=0.74) (all P<0.01). Elderly specimen (>or=70 years) showed better intersite correlations between all regions than younger specimen (<70 years). CONCLUSION: High correlations between contralateral BMD values may be the result of similar biomechanical loading conditions. Although a relationship between proximal and distal bone quality of the same bone was found, the moderate coefficient suggests that ipsilateral measurements do not provide a good prediction of humeral head BMD. Bone quality at the humeral head is best predicted by BMD measurements at the contralateral location rather than the ipsilateral distal site.

Absorptiometry, Photon↗
PubMed1997

The prognosis of fetuses with a shortened femur and humerus length before 20 weeks of gestation.

OBJECTIVE: The purpose of this study was to evaluate the prognosis of fetuses with a shortened femur and humerus length detected at earlier than 20 weeks of gestation. METHODS: The study population consisted of 549 Japanese pregnant women. The prognosis of the shortened femur and humerus length fetuses was evaluated and the predictivity of the shortened femur and humerus length for chromosomal abnormalities and structural malformations was also calculated. RESULTS: All seven shortened femur and humerus length fetuses had some kind of structural malformations and three fetuses also had chromosomal abnormalities. The detection rate, positive predictive value and false positive rate for structural malformations were 17.9%, 100% and 0%, respectively. The positive predictive value for chromosomal abnormalities was 43%. CONCLUSION: The shortened femur and humerus length fetuses in Japanese women demonstrated an increased risk of structural malformations, especially in the cardiovascular system, as well as chromosomal abnormalities.

Adult↗
PubMed2005

[Supracondylar process and supratrochlearforamen of the humerus: a case report and a review of the literature].

UNLABELLED: The authors present a case where the main variants of the humerus were associated on the same specimen: the supracondylar process and the supratrochlear foramen. The supracondylar process, a bony prominence situated on the anteromedial surface of the humerus in the vicinity of the medial epicondyle, could be at the origin of ulnar or median nerve and brachial artery compression syndromes, especially when associated with Struthers' ligament. MATERIAL AND METHOD: The anatomic specimen was discovered accidentally during a larger study aimed at establishing a current norma anatomica and morphometry of the humerus. The supracondylar process and the supratrochlear foramen were morphologically and morphometrically analyzed. RESULTS AND DISCUSSION: The supracondylar process was situated on the anteromedial surface of a left humerus, roughly 5 cm above the medial epicondyle. It was 12.4 mm in length, mediodistally directed. The supratrochlear foramen was situated above the lateral part of the humeral trochlea, just adjacent to the middle branch of trifurcation of the anterior border of the humerus. It was ovoid in shape with the long axis transversally (6.3/3.7 mm). CONCLUSIONS: Presentation of such variants contributes to increasing the anatomical data capital and might be important for diagnosis of peripheral neurovascular compression syndromes.

Adolescent↗
PubMed2001

Reconstruction of the proximal humerus with the clavicle after tumor resection: a case report.

Reconstruction of the proximal humerus after resection for tumor and modification of the clavicular transposition procedure is described in which the blood supply of the clavicle is preserved and the clavicle is used to bridge the defect. An 11-year-old boy presented with shoulder pain, and the diagnosis was osteosarcoma of the right proximal humerus. After resection of the sarcomatous proximal humerus, the clavicle was released with its periosteum remaining intact, and the clavicle was rotated downward around the acromioclavicular joint. A vascularized fibula supplemented the reconstruction in trying to gain length of the arm. The acromioclavicular joint and the vascular supply of the clavicle were preserved. Internal fixation from the clavicle and the fibula to the distal humerus was made with an AO plate and screws. Muscles around the proximal humerus were reattached to the clavicle. Range of motion of the shoulder was 80 degrees flexion, 85 degrees abduction, 30 degrees external rotation, and 90 degrees internal rotation. Although the postoperative followup is relatively short, only 2 years, the functional advantages of this operation over other forms of reconstruction can be observed.

Bone Neoplasms↗
PubMed1999

Correlation of medial/lateral rotation of the humerus with glenohumeral translation.

OBJECTIVES: To correlate glenohumeral translation in the anterior/posterior direction with medial and lateral rotation of the humerus. In addition, the length of the anterior and posterior component of the glenohumeral capsuloligamentous complex was varied in order to gain insight into the contribution of each component to limiting translation. All measurements were made with the humerus positioned at 90 degrees of abduction and 0 degrees of flexion/ extension. METHODS: Six fresh cadaveric shoulders were used. Each scapula was mounted in a cement pot to rest it in its correct anatomical position. Seven tests were carried out on each shoulder. A series of measurements of translation of the humerus in the anterior direction and posterior direction were taken at 20 degrees intervals of lateral rotation and then at 20 degrees intervals of medial rotation until the limit of lateral or medial rotation had clearly been reached (test 1). The capsuloligamentous complex was then incised and a beaded chain and catches were sutured across the joint to mimic the capsuloligamentous complex at different lengths (tests 2 to 7). RESULTS/CONCLUSIONS: (a) When the glenohumeral capsuloligamentous complex is intact, the humerus translates maximally in the glenoid (between 20 and 30 mm) when the humerus is between 40 degrees and 100 degrees of lateral rotation. (b) As the glenohumeral capsuloligamentous complex increases in length, so does the extent of translation. (c) In medial rotation, the length of the posterior capsule, rather than the length of the anterior capsule, has the greater effect on anterior/posterior translation. (d) In lateral rotation the length of the anterior capsule, rather than the length of the posterior capsule, has the greater effect on anterior/posterior translation. (e) The glenohumeral ligamentous complex acts more as a cuff, enclosing the joint, rather than as a sling, as is commonly thought.

Aged↗
PubMedDate not supplied

Radioanatomical measurements of the medullary cavity of the humerus in Kuwait: ethnic differences and clinical implications for fracture fixation.

OBJECTIVE: To compare the difference in diameter of the medullary cavity of the humerus in Arab and South Asian patients in Kuwait. SUBJECTS AND METHODS: In 46 patients (29 Arab, 17 South Asian) treated at Al-Razi Hospital, Kuwait, for diaphyseal fracture of the humerus, the medullary cavity of the humerus on the radiographs of the uninjured (contralateral side) was examined. Bone density was also measured. Statistical significance was calculated by parametric and nonparametric test using SPSS package. RESULTS: South Asians had a significantly narrower medullary cavity (p < 0.05) and higher cortical indices (p < 0.05) than Arabs, and also a narrower external diameter of the humerus at levels 5 and 6 (p < 0.05). CONCLUSION: In cases of fracture of the humerus, radiographic measurements of the diameter of the medullary cavity of the uninjured side were essential in selecting the appropriate fixation device.

Adult↗