Variations of third head of biceps may present as a group of accessory fascicles arising from the coracoid process, the pectoralis major tendon, head of humerus
, articular capsule of humerus or from shaft of humerus itself.
In a study done by Lokanadham et al, the maximum transverse diameter of head of humerus
X ray showed severe osteophytic changes and a subtle bony outgrowth arising from head of humerus
extending inferiorly along the medial aspect of humerus.
In the antegrade approach, it is essential to ensure that proximal end of the nail is deep to the articular surface of head of humerus
to reduce impingement.
The therapist kneels laterally and superiorly to the patients shoulder and positions his two thumbs back to back, with the tips in contact with the posterior surface of the head of humerus
adjacent to the acromion process and pointing towards ceiling.
1 patient had avascular necrosis of the head of humerus
and was eventually treated by shoulder hemiarthroplasty.
They can manifest as a cluster of accessory fascicles arising from coracoids process, pectoralis minor tendon, proximal head of humerus
or articular capsule of humerus .