Morphometric and Radiological Study of the Bicipital Groove in Adults: Clinical Relevance in Shoulder Surgery – A Prospective Study

Background: The bicipital groove (intertubercular sulcus) of the humerus is an important anatomical structure that houses the tendon of the long head of the biceps brachii muscle. The changes in the morphology and size of the bicipital groove can affect the stabilisation of the biceps tendon and are related to such conditions as tendinitis, tendon subluxation, and shoulder impingement syndrome. Morphometric and radiological assessment of the bicipital groove is thus clinically significant for the design of shoulder surgeries and orthopaedic procedures. The aim is to test morphometric and radiological features of the bicipital groove in grown-up patients and to test their clinical applicability in surgery on the shoulder. Material and Methods: This was a prospective study conducted in Mumbai over 1 year. Eighty-0 adults who had radiographic evaluation of their shoulders were included. Standard shoulder radiographs and CT were used to measure the bicipital groove radiologically. Groove length, width, depth, medial wall angle and lateral wall angle were the parameters that were evaluated. Statistical analysis was conducted using descriptive and comparative methods. Results: The bicipital groove mean width was 9.8 +/- 1.9 mm, the mean depth was 5.2 +/- 1.1 mm, and the mean length was 42.6 +/- 4.5 mm. Most of the subjects were normal in morphology (60%). In 25 per cent, a shallow coulee was seen, and in 15 per cent, a narrow coulee was observed. The depth of the grooves differed significantly between male and female subjects (p < 0.05). The shapes also varied, which was linked to a higher risk of biceps tendon instability. Conclusion: The research indicates a significant difference in the morphometric and radiographic appearance of the bicipital groove in adults. Such differences have significant effects on shoulder pathology and on the decision to undergo surgery. Being aware of these types of anatomical differences can help a surgeon enhance diagnostic accuracy and surgical outcomes in shoulder surgeries.

Keywords: Shoulder surgery, Bicipital groove, Morphometry, Humerus, Biceps tendon.