{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T10:03:49Z","timestamp":1783764229104,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,26]],"date-time":"2020-12-26T00:00:00Z","timestamp":1608940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2020,12,26]],"date-time":"2020-12-26T00:00:00Z","timestamp":1608940800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2020,12,26]],"date-time":"2020-12-26T00:00:00Z","timestamp":1608940800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,12,26]],"date-time":"2020-12-26T00:00:00Z","timestamp":1608940800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,9,11]],"date-time":"2020-09-11T00:00:00Z","timestamp":1599782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["arthroscopysportsmedicineandrehabilitation.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare the likelihood of spiral fracture of the humerus using torsional load to failure after intraosseous biceps tenodesis at the position of the arthroscopic suprapectoral tenodesis versus the subpectoral meta\u2010diaphyseal location.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Eight matched pairs of humeri were dissected. Unicortical tenodesis holes were drilled, either at the bottom of the bicipital groove (group 1) or just below the pectoralis major tendon insertion (subpectoral) in the humeral diaphysis (group 2). Tenodesis was performed in a 7\u2010mm bone tunnel, with suture fixation distal to this site using 2 separate 2\u2010mm holes, secured with No. 2 polyester suture. Each humerus was potted in plaster and mounted to a hydraulic torsional load frame, consistent with previously validated models for creating humeral spiral fractures. External rotation torque was applied to each humerus distally until fracture occurred. The paired\n                      <jats:italic>t<\/jats:italic>\n                      test was used to compare the 2\u00a0groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fracture occurred at the subpectoral cortical drill hole in all 8 specimens in group 2. In group 1, only 2\u00a0fractures occurred through the tenodesis hole, with spiral fracture resulting in the diaphysis of the humerus in 6 of 8\u00a0specimens. Average torque to failure measured 31.35 Nm in group 1 and 25.08 Nm in group 2; the difference was statistically significant (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Subpectoral cortical drill holes for biceps tenodesis were shown to be a stress riser for humeral spiral fracture. Suprapectoral cortical drill holes were shown to be significantly less of a stress riser. The amount of torque required to fracture the humerus through the subpectoral drill holes was less than with the suprapectoral drill holes. Only 2 fractures occurred through the suprapectoral tenodesis holes, and significantly more torque was required to create these fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Clinically, the difference between suprapectoral and subpectoral tenodesis fracture potential should be considered when selecting a tenodesis location.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2020.08.011","type":"journal-article","created":{"date-parts":[[2020,12,26]],"date-time":"2020-12-26T07:37:26Z","timestamp":1608968246000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"title":["Implant\u2010Free Subpectoral Biceps Tenodesis Is Biomechanically at Higher Risk of Spiral Fracture of the Humerus Compared With Implant\u2010Free Suprapectoral Biceps Tenodesis"],"prefix":"10.1002","volume":"3","author":[{"given":"Arash A.","family":"Dini","sequence":"first","affiliation":[{"name":"Private Practice Encino California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua E.","family":"Mizels","sequence":"additional","affiliation":[{"name":"Morsani College of Medicine University of South Florida Tampa Florida U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohale","family":"Sadeghpour","sequence":"additional","affiliation":[{"name":"Memorial Hermann Memorial City Medical Center Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Tulane University New Orleans Louisiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Felix H.","family":"Savoie","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Tulane University New Orleans Louisiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark H.","family":"Getelman","sequence":"additional","affiliation":[{"name":"Southern California Orthopedic Institute Van Nuys California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,26]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1943.01220150064005"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-194830020-00001"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/otsm.2003.35887"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2011.02.020"},{"key":"e_1_2_2_6_2","first-page":"E61","article-title":"Proximal humerus fracture after keyhole biceps tenodesis","volume":"39","author":"Reiff S.N.","year":"2010","journal-title":"Am J Orthop (Belle Mead 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Published by Elsevier Inc. on behalf of the Arthroscopy Association of North America.","name":"copyright","label":"Copyright"}]}}