title: The anatomic relationship between the morphology of the greater tubercle of the humerus and the insertion of the infraspinatus tendon.
abstract: BACKGROUND
  The objective of this study was to evaluate the topographic relationship between the morphology of the greater tubercle and the insertion of the tendon of the infraspinatus.
  
  
  METHODS
  First, we defined an impression of the greater tubercle, which has not been recognized in classic textbooks, as the "lateral impression" and then measured the dimensions of the "lateral impression" of the greater tubercle in 71 samples of dry bone of humeri. Next, we examined 16 cadaveric humeri with rotator cuff tendons by micro-computed tomography to analyze the positional relationship between the lateral impression and the infraspinatus tendon.
  
  
  RESULTS
  In all samples of dry bones, the lateral impression could be identified as a triangle shape. The lateral impression was composed of the border with the highest impression (mean, 6.3 mm), the border with the middle impression (mean, 5.0 mm), and the border with the lateral wall of the greater tubercle (mean, 8.5 mm). In all samples of humeri with rotator cuffs, we could confirm the lateral impression, and the border between the highest impression and the lateral impression corresponded to the anterior border of the insertion of the infraspinatus tendon.
  
  
  CONCLUSIONS
  We propose a new anatomic concept of the lateral impression that could enable the precise diagnosis of and facilitate repair techniques for infraspinatus tear, according to specific anatomic characteristics, by applying 3-dimensional computed tomography assessment preoperatively.
authors.affiliation: Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Radiology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Taiki
authors.initials: T
authors.lastname: Nozaki
authors.affiliation: Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: a-nim@sol.dti.ne.jp.
authors.forename: Akimoto
authors.initials: A
authors.lastname: Nimura
authors.affiliation: Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Fujishiro
authors.affiliation: Department of Joint Reconstruction, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Mochizuki
authors.affiliation: Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Yamaguchi
authors.affiliation: Nokyo Kyosai Research Institute, Tokyo, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kato
authors.affiliation: Shoulder and Elbow Service, Funabashi Orthopaedic Sports Medicine Center, Funabashi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugaya
authors.affiliation: Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Akita
mesh_terms: D002102:Cadaver; D004838:Epiphyses; D006801:Humans; D006811:Humerus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D021621:Imaging, Three-Dimensional; D017006:Rotator Cuff / Q000000981:diagnostic imaging; D013710:Tendons / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D055114:X-Ray Microtomography
keywords: Greater tubercle; highest impression; infraspinatus; lateral impression; micro-CT; middle impression