Osteoanatomy of the adult humerus for rehabilitative assessment: Referenced to the NIH visible human project (NIH-VHP)

A Reference-Humerus model was developed for rehabilitation applications based on the NIH Visible Human Project. The model was comprised of (i) a physical model (H-VHP) and (ii) the associated 3D computational geometry. Anatomic characterization and evaluation with published human humeral anatomic data provide anatomic validation for clinical, rehabilitative applicability. Using CT-based 3D computational methods, geometric definitions of specific humeral landmarks were established by sequentially defining best fits, axes, and coordinate systems. Key surgical osteoanatomy parameters were then determined. Measured whole bone parameters included length and retroversion. Proximal articular parameters included articular surface radius, humeral head height, and humeral head medial, posterior, and total offsets. Proximal nonarticular parameters include inclination, head to greater tuberosity height, greater tuberosity width, and lateral offset, and lesser tuberosity anterior offset. Distal parameters included trochlear sulcus and capitellum radii of curvature, and distal flexion-extension axis anterior and medial offsets. All measured anatomic parameters of the Reference-Humerus lay within or very close to respective ranges that were derived by pooling data from published studies on human (cadaveric and live) humeri. Based on measurements, the Reference-Humerus has application as a rehabilitative and surgical tool to analyze proximal (shoulder) and distal (elbow) joint loading, and assistive device loads (walkers, crutches, canes, wheelchairs), and to develop accurate numerical models as an adjunct to presurgical planning and postsurgical follow-up (humeral nails, shoulder and elbow arthroplasty implants).