title: Radiographic landmark for humeral head rotation: a new radiographic landmark for humeral fracture fixation.
abstract: BACKGROUND
  There is no definite radiographic landmark in plain radiographs for proximal humeral rotation, which is an important parameter for avoiding rotational malalignment during fracture fixation. Here, we used radiographic images of cadaveric humeri to determine whether the landmark of the crest of lesser tuberosity (CoLT) in plain radiographs could be used to determine humeral rotation.
  
  
  METHODS
  Twenty adult cadaveric humeri were collected and seven consecutive radiographic anteroposterior views (45°, 30°, 15° internal rotation; neutral rotation; and 15°, 30°, 45° external rotation) were obtained for each specimen.
  
  
  RESULTS
  The proportional distance (PD) of the CoLT landmark relative to the humeral head was measured and analysed. The mean PDs of the CoLT landmark were 10.2%, 17.9%, 25.6%, 35.9%, 53.4%, and 62.9% of the diameter of the humeral head, corresponding to 45°, 30°, and 15° external rotation, neutral rotation, and 15° and 30° internal rotation, respectively. We found significant differences in the mean PDs with humeral rotation.
  
  
  CONCLUSIONS
  The projection of the CoLT in plain radiographs can be used as an important landmark to assess humeral head rotation and will be a useful landmark for rotational control of fracture fixation.
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China. Electronic address: juntan7401@gmail.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Tan
authors.affiliation: Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea. Electronic address: hjleeleehj@gmail.com.
authors.forename: Hyun-Joo
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, Republic of Korea. Electronic address: syugyosha@yahoo.com.
authors.forename: Iman
authors.initials: I
authors.lastname: Aminata
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, Republic of Korea. Electronic address: asanshoulder@gmail.com.
authors.forename: Jae-Myeung
authors.initials: JM
authors.lastname: Chun
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, Republic of Korea. Electronic address: dr.aashayk@gmail.com.
authors.forename: Aashay L
authors.initials: AL
authors.lastname: Kekatpure
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, Republic of Korea. Electronic address: jeonchoi@gmail.com.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Jeon
mesh_terms: D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D005592:Fracture Fixation; D017759:Fractures, Malunited / Q000473:pathology*; D006801:Humans; D006810:Humeral Fractures / Q000473:pathology*; D006811:Humerus / Q000033:anatomy & histology / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012399:Rotation
keywords: Crest of lesser tuberosity; Humeral head; Radiographic; Rotational profile