Table of Contents  
ORIGINAL ARTICLE
Year : 2015  |  Volume : 25  |  Issue : 1  |  Page : 1-3

Anthropometric study of bicipital groove and its clinical implication


Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, Karnataka, India

Date of Acceptance21-Mar-2015
Date of Web Publication20-Jul-2015

Correspondence Address:
Dr. Chandni Gupta
Department of Anatomy, Kasturba Medical College, Manipal - 576 104, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1116-5898.161210

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  Abstract 

Objective: Bicipital groove along with the transverse humeral ligament bridging it offers stability and smooth functioning of the tendon of long head of biceps brachii muscle and prevents its subluxation during multidirectional biomechanical movements of arms. Hence, various anatomical information of the bicipital groove is vital as deformities of the bicipital tendon and its synovial sheath have been associated with a variety of reasons of shoulder pain and disability. Therefore, an attempt is made in this study to determine the length, width, and depth of bicipital groove along with the transverse diameter, anterior-posterior diameter and length of the humerus. Materials and Methods: The study was carried out on 60 unpaired dry humeri (right = 33, left = 27). The length, depth and width of the bicipital groove were measured using the vernier caliper. Results: The mean length, width and depth of the bicipital groove in the present study were 7.41, 1.08 and 0.55 cm. The mean length, width and A-P diameter of the humerus in the present study were 30.4, 3.0 and 2.6 cm. In the present study, the mean length of the bicipital groove corresponded to 24.37% of the total length of humerus, the mean width was 36% of the total humeral width, and the mean depth was 21.1% of the total anteroposterior width of the humerus. There was no significant correlation between right and left side as P > 0.05. Conclusion: This study determined the morphometric parameters of the bicipital groove and will be important for anthropologists, orthopedic surgeons, and clinical anatomists.

Keywords: Bicipital groove, humerus, morphometry


How to cite this article:
Gupta C, Jaiswal S, D'souza AS. Anthropometric study of bicipital groove and its clinical implication. Niger J Surg Sci 2015;25:1-3

How to cite this URL:
Gupta C, Jaiswal S, D'souza AS. Anthropometric study of bicipital groove and its clinical implication. Niger J Surg Sci [serial online] 2015 [cited 2019 Sep 15];25:1-3. Available from: http://www.njssjournal.org/text.asp?2015/25/1/1/161210


  Introduction Top


The humerus is the longest and largest bone in the upper limb; it has expanded ends and a shaft. The rounded head occupies the proximal and medial part of the upper end of the bone and forms an enarthrodial articulation with the glenoid cavity of the scapula. The lesser tubercle projects from the front of the shaft, near the head, and is limited on its lateral side by a well-marked groove. The greater tubercle is the most lateral part of the proximal end of the humerus. The distal end is attached to the forearm bones at the elbow joint. [1]

It provides support to the major muscles of the shoulder, the arm as well as the forearm. It also provides anchor to three nerves namely, axillary, radial, ulnar, which are essential functional components of the shoulder, arm, and forearm. Because of its structure and physiology, the humerus is indeed very important in the proper functioning and movement of the entire upper extremity. Fracture in any section of the humerus can lead to the impairment or loss of certain essential functions of the shoulder, the arm, and the hand.

The intertubercular sulcus is between the greater and lesser tubercles, and it continues distally for approximately 5 cm on the shaft of the humerus, which overall is termed as the bicipital groove. [2] It contains the long head of the biceps brachii muscle, its synovial sheath and an ascending branch of the anterior circumflex humeral artery. Its lateral lip has the insertion of the bilaminar tendon of the pectoralis major, its floor has the tendon of the latissimus dorsi and its medial lip has the tendon of the teres major. The transverse humeral ligament is a wide band that bridges the sulcus and converts the sulcus into a canal and acts as a retinaculum for the long tendon of the biceps. [1]

Morphometry of bicipital groove can affect the functions of neighboring structures leading to several pathological disorders. [3]

An understanding of normal humeral morphology is vital, since the restoration of normal anatomy is the aim in prosthetic replacement of the upper end of the humerus. This information can aid in finding the prosthetic size, its positioning, and design. [4]

Therefore, this study was carried out to examine the length, width and depth of bicipital groove and humerus and to correlate various parameters of bicipital groove with the parameters of the humerus.


  Materials and Methods Top


The study included 60 unpaired dry humeri (33 right and 27 left sides). The humeri did not have any external deformities.

The upper ends of all bones were studied. The length, width and depth of the bicipital groove were measured with a vernier caliper [Figure 1].
Figure 1: Measurements done on bicipital groove and humerus

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The length of the humeri was measured using a ruler. The anteroposterior and transverse width of the humeri was measured at the surgical neck with a vernier caliper [Figure 1].

Statistical analysis of the measured parameters was done using SPSS software (IBM SPSS Statistics for Windows version 20.0, USA).


  Results Top


Mean and range of all parameters of humeri and bicipital groove are shown in [Table 1], [Table 2] and [Table 3].
Table 1: Mean and range of parameters of total humeri

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Table 2: Mean and range of parameters on right side of humeri

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Table 3: Mean and range of parameters on left side of humeri

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All the values were slightly more on the left side as compared to right side except the width of the humerus that was slightly more on the right side.

The mean length of the bicipital groove corresponded to 24.37% of the total length of humerus, the mean width was 36% of the total humeral width, and the mean depth was 21.1% of the total anteroposterior width of the humerus.

There was no significant correlation between right and left side of length, A-P diameter and width of the humerus as the P value was 0.911, 0.757 and 0.174 using paired sample t-test in SPSS software 16 (IBM SPSS Statistics for Windows version 20.0, USA). Even there was no significant correlation between the length, width and depth of right and left side of bicipital groove of the humerus as the P value was 0.576, 0.772 and 0.184.


  Discussion Top


The mean length, width and depth of the bicipital groove in the present study were 7.41, 1.08 and 0.55 cm which corresponds to 24.37, 36 and 21.1% of the total length, width and A-P diameter of the humerus while in study conducted by Murlimanju et al., Wafae et al. they got the values as 8.46, 8.1 for length of humerus, 0.85, 1.01 for width of humerus and 0.44, 0.40 cm for depth of humerus, respectively which corresponds to their 27.8, 25.2% of the total length 32.2, 49.7-54.5% of the width of humerus and 17%, 18.8% of the A-P diameter of humerus. [5],[6]

Rajani and Man found the mean length and width of bicipital groove as 8 and 1.2 cm, which correspond to 26.7% and 52% of the total length and width of the humerus. [7]

The mean length of the humerus, width and A-P diameter in the present study was 30.4, 3.0 and 2.6 cm which were similar to the values got by Murlimanju et al. as 30.4, 2.64 and 2.59 cm, respectively. [5] According to Vettivel et al. the mean length of the right humeri was 30.2 ± 0.2 cm and the left was 30.1 ± 0.2 cm while in our study it was 30.43 ± 1.63 on right side and 30.37 ± 2.37 on left side. [3]

Rajani and Man found the mean length and width of the humerus as 30, 2.3 cm respectively. [7]

On patient radiographs, Cone et al. found that the mean depth of the intertubercular sulcus was 0.46 cm. They also stated that 90% of their patients had a sulcus with a depth more than 3 mm, and 86% had a depth in the range of 4-6 mm. Finally, they thought that a groove 3 mm deep or less must be noticed with doubt in handling pathologic disorders of the shoulder. [8]

The tendon of the long head of the biceps plays a significant role in sustaining the configuration of the head of the humerus inside the glenoid cavity of the scapula. [9] Subluxation and dislocations of the biceps tendon are more common in individuals with a shallow intertubercular sulcus. [10]

During rotation of the shoulder, a shallow bicipital groove can cause injury to the biceps tendon because of impingement of structures like the acromion, rotator cuff, and coracoacromial arch. [11] The morphology of the bicipital groove has substantial variability and affects the biomechanics of the tendon, and certain morphologic features have been associated with the development of bicipital tendinitis. [12]

 
  References Top

1.
Ellis H, Healy JC, Johnson D, Williams A. Gray's anatomy. In: Standring S, editor. The Anatomical Basis of Clinical Practice. 39 th ed. Spain: Churchill Livingstone; 2006. p. 823-32.  Back to cited text no. 1
    
2.
Joseph J. Locomotor system. In: Hamilton WJ, editor. Textbook of Human Anatomy. London: Macmillan; 1976. p. 19-200.  Back to cited text no. 2
    
3.
Vettivel S, Indrasingh I, Chandi G, Chandi SM. Variations in the intertubercular sulcus of the humerus related to handedness. J Anat 1992;180 (Pt 2):321-6.  Back to cited text no. 3
    
4.
Robertson DD, Yuan J, Bigliani LU, Flatow EL, Yamaguchi K. Three-dimensional analysis of the proximal part of the humerus: Relevance to arthroplasty. J Bone Joint Surg Am 2000;82-A: 1594-602.  Back to cited text no. 4
    
5.
Murlimanju BV, Prabhu LV, Pai MM, Shreya M, Prashanth KU, Kumar CG, et al. Anthropometric study of the bicipital groove in Indians and its clinical implications. Chang Gung Med J 2012;35:155-9.  Back to cited text no. 5
    
6.
Wafae N, Atencio Santamaría LE, Vitor L, Pereira LA, Ruiz CR, Wafae GC. Morphometry of the human bicipital groove (sulcus intertubercularis). J Shoulder Elbow Surg 2010;19:65-8.  Back to cited text no. 6
    
7.
Rajani S, Man S. Review of bicipital groove morphology and its analysis in North Indian population. ISRN Anat 2013; 2013. P. 1-7.  Back to cited text no. 7
    
8.
Cone RO, Danzig L, Resnick D, Goldman AB. The bicipital groove: Radiographic, anatomic, and pathologic study. AJR Am J Roentgenol 1983;141:781-8.  Back to cited text no. 8
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9.
Martinoli C, Bianchi S, Prato N, Pugliese F, Zamorani MP, Valle M, et al. US of the shoulder: Non-rotator cuff disorders. Radiographics 2003;23:381-401.  Back to cited text no. 9
    
10.
Hitchcock HH, Bechtol CO. Painful shoulder; observations on the role of the tendon of the long head of the biceps brachii in its causation. J Bone Joint Surg Am 1948;30A: 263-73.  Back to cited text no. 10
[PUBMED]    
11.
DePalma AF. Surgical anatomy of the rotator cuff and the natural history of degenerative periarthritis. Clin Orthop Relat Res 2008;466:543-51.  Back to cited text no. 11
[PUBMED]    
12.
Karistinos A, Paulos LE. Anatomy and function of the tendon of the long head of the biceps muscle. Oper Tech Sports Med 2007;15:2-6.  Back to cited text no. 12
    


    Figures

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    Tables

  [Table 1], [Table 2], [Table 3]



 

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