Reliability of the Radiographic Parameters in Pediatric Supracondylar Fracture

Yoon Hae Kwak; Dong Jou Shin; Kun Bo Park

doi:10.12671/jkfs.2010.23.1.90

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Kwak, Shin, and Park: Reliability of the Radiographic Parameters in Pediatric Supracondylar Fracture

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2010; 23(1): 90-96.

Published online: 31 January 2010

DOI: https://doi.org/10.12671/jkfs.2010.23.1.90

Reliability of the Radiographic Parameters in Pediatric Supracondylar Fracture

Yoon Hae Kwak, M.D., Dong Jou Shin, M.D., Kun Bo Park, M.D.^*

Department of Orthopaedic Surgery, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.

^*Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

Address reprint requests to: Kun Bo Park, M.D. Department of Orthopaedic Surgery, Yonsei University College of Medicine, 134, Sinchon-dong, Seodaemun-gu, Seoul 120-752, Korea. Tel: 82-2-2228-2187, Fax: 82-2-363-1139, kunbopark@gmail.com

Received 25 September 2009 Revised 30 November 2009 Accepted 29 December 2009

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To suggest the most reliable guideline of the treatement for the supracondylar fracture in children by the comparison of the radiographic parameters between forearm supination-elbow extension and forearm pronation-elbow flexion view.

Materials and Methods

A total of seventy-one patients were included in the study. Baumann, metaphyseal diaphyseal and medial epicondylar epiphyseal angle of normal elbow in extension and flexion view were compared. Finally, the results of Group I (operation with elbow extension view) and Group II (operation with elbow flexion view) were compared.

Results

Intraobserver reproducibility and interobserver reliability were better in the Baumann angle with extension view and metaphyseal diaphyseal angle with flexion view. In extension view, Baumann and metaphyseal diaphyseal angle show negative correlation with carrying angle but in flexion view, only metaphyseal diaphyseal angle shows negative correlation. Baumann angle were greater in flexion view and medial epicondylar epiphyseal angle were greater in extension view. There was no statistical difference in the final results of Group I and II.

Conclusion

Baumann angle was more effective in forearm supination-elbow extension view and metaphyseal diaphyseal angle was more effective in forearm pronation-elbow flexion view. The difference between elbow extension and flexion view should be considered during operation.

Keywords: Humerus, Supracondylar fracture, Baumann angle, Metaphyseal diaphyseal angle, Medial epicondylar epiphyseal angle, Carrying angle

Figures and Tables

Fig. 1

(A) Forearm supination-elbow extension view.

(B) Forearm pronation-elbow flexion view.

Fig. 2

Measurement in forearm supination-elbow extension view.

(A) Baumann angle.

(B) Metaphyseal diaphyseal angle.

(C) Medial epicondylar epiphyseal angle.

Fig. 3

Measurement in forearm pronation-elbow flexion view.

(A) Baumann angle.

(B) Metaphyseal diaphyseal angle.

(C) Medial epicondylar epiphyseal angle.

Table 1

Intraobserver reproducibility of each radiographic parameters

^*Baumann: Baumann angle, ^†MDA: Metaphyseal diaphyseal angle, ^‡MEEA: Medial epicondylar epiphyseal angle.

Table 2

Interobserver reliability of each radiographic parameters

^*Baumann: Baumann angle, ^†MDA: Metaphyseal diaphyseal angle, ^‡MEEA: Medial epicondylar epiphyseal angle.

Table 3

Correlation between carrying angle and other radiographic parameters

^*Baumann: Baumann angle, ^†MDA: Metaphyseal diaphyseal angle, ^‡MEEA: Medial epicondylar epiphyseal angle.

Table 4

Mean differences (extension view-flexion view) between extension and flexion views (degrees)

^*Baumann: Baumann angle, ^†MDA: Metaphyseal diaphyseal angle, ^‡MEEA: Medial epicondylar epiphyseal angle.

Table 5

Comparison of the finalresults between groups (degrees)

Values are mean±standard deviation.

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