The humeral head is covered by hyaline cartilage forming a smooth articular hemisphere approximately 30 mm in radius. The articular surface faces medially, superiorly, and posteriorly in the anatomical position, with the retroversion angle averaging 20-30 degrees relative to the transcondylar axis.
| Articulations |
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|---|---|
| Landmarks |
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| Ossification | Ossification of the humeral head begins at birth (primary centre). The greater and lesser tubercle secondary centres appear at 1-2 and 4-5 years respectively, all fusing at 6-7 years. |
The humeral head articular surface is the site of Hill-Sachs lesions from anterior shoulder dislocation, where the posterosuperior humeral head impacts the anterior glenoid rim. MRI and CT quantify Hill-Sachs lesion size and depth to determine whether it engages with the glenoid. Large engaging Hill-Sachs lesions require remplissage (infraspinatus tenodesis) or Latarjet procedure to restore stability. Avascular necrosis of the humeral head affects this surface first.
An impaction fracture of the posterolateral humeral head caused by the glenoid rim during anterior dislocation.
Loss of blood supply after fracture, steroid use, or other causes leads to collapse of the articular surface.
Wear of the articular cartilage of the humeral head and glenoid causes pain and loss of rotation.
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