title: Utilization of the bicipital groove axis for confirming alignment of the humerus with transepicondylar and ulnar shaft axes during intramedullary nailing.
abstract: OBJECTIVE
  Intramedullary nailing is the preferred surgical treatment of humerus shaft fractures. The purpose of this study was to investigate the relationship between the bicipital groove and specific anatomical landmarks in achieving correct alignment of the humerus during intramedullary nailing, and to describe these anatomical landmarks.
  
  
  METHODS
  Thirty (15 right; 15 left) total upper cadaver extremities were used in this study. After the anatomical landmarks were identified and marked, humeral head axis, transepicondylar axis, ulnar shaft axis, bicipital groove axis, and angular measurements of these were obtained.
  
  
  RESULTS
  The mean angle between the bicipital groove axis and transepicondylar axis was 48.17°±12.35º (range: 20.10º to 74.6º). The mean angle between the bicipital groove axis and ulna diaphysis axis was 41.82º±11.56 º (range: 17.91º to 68.27º). The mean angle between the humeral head axis and bicipital groove axis was 20.53°±3.90º (range: 11.85º to 31.81º). The mean retroversion angle between the humeral head axis and transepicondylar axis was 27.52±11.37º (range: 4.26º to 49.36º). The mean angle between the humeral head axis and ulna diaphysis axis was 61.73º±12.08º (range: 33.97º to 86.37º). The mean torsion angle was 62.58º±11.28 º (range: 40.74º to 85.74º).
  
  
  CONCLUSIONS
  Measurement and utilization of the relationship between the bicipital groove, ulna diaphysis and transepicondylar axes may be used for restoring humeral rotation.
authors.affiliation: Balıkesir University Faculty of Medicine, Department of Orthopedics and Traumatology, Balıkesir, Turkey. drgokhanmeric@gmail.com.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Meriç
authors.affiliation: Dokuz Eylul University Faculty of Medicine, Department of Anatomy, İzmir, Turkey.
authors.forename: Gülşah
authors.initials: G
authors.lastname: Zeybek
authors.affiliation: Dokuz Eylul University Faculty of Medicine, Department of Anatomy, İzmir, Turkey.
authors.forename: Amaç
authors.initials: A
authors.lastname: Kıray
authors.affiliation: Balıkesir University Faculty of Medicine, Department of Orthopedics and Traumatology, Balıkesir, Turkey.
authors.forename: Aziz
authors.initials: A
authors.lastname: Atik
authors.affiliation: SANKO University, Sani Konukoğlu Hospital, Department of Orthopaedics and Traumatology, Gaziantep, Turkey.
authors.forename: Aydın
authors.initials: A
authors.lastname: Budeyri
authors.affiliation: Balıkesir University Faculty of Medicine, Department of Orthopedics and Traumatology, Balıkesir, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Koşay
mesh_terms: D019643:Arthroplasty, Replacement; D002102:Cadaver; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D058430:Humeral Head / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D014057:Tomography, X-Ray Computed