Journal of Musculoskeletal Trauma

Reliability of the Radiographic Parameters in Pediatric Supracondylar Fracture: Yoon Hae Kwak, Dong Jou Shin, Kun Bo Park; J Korean Fract Soc 2010;23(1):90-96. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.90

Abstract PDF: 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.

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Assessments of Reduction for Supracondylar Humerus fractures in Children: Comparison of Clinical carrying angle, Baumanns angle and Metaphyseal-diaphyseal angle: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyeong Lee, Seong Hwan Kim; J Korean Soc Fract 1999;12(3):660-666. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.660

PURPOSE
The object of this retrospective study is to verify Baumanns angle as assessment methods of reduction for supracondylar fracture of the humerus in children and to confirm what is the more accurate assessment methods of supracondylar fracture of the humerus between Baumanns and metaphyseal-diaplyseal angle.
MATERIALS AND METHODS
34 cases of more than 1 years follow up after closed reduction and pinning were reviewed. Simple linear regression has been used for statistical analysis and Pearsons correlation coefficient(rho) has been used for comparison of Baumanns angle and metaphy seal-diaphyseat angle.
RESULTS
The results form simple linear regression, about a 10 change in Baumanns angle contributes to a change in the carrying angle of approximately 3.7 on the uninjured(=-0.372, r=-0.750, P<0.001) and injured( =-0.365, r=-0.759, P<0.001) arms. In comparison of Baumanns angle and metaphyseal-diaphyseal angle to predict final carrying angle, the correlation coefficient between Baumanns angle and carrying angle(r=-0.759) was higher than that between metaphyseal-diaphyseal angle and carying angle(r=-0.495) with statistical significant using Fishers rho(P<0.05).
CONCLUSION
The Baumannss angle after reduction can be reliably used to predict accurately the final carrying angle and is more accurate than the metaphyseal-diaphyseal angle to predict the final carrying angle.

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Reliability of the Radiographic Parameters in Pediatric Supracondylar Fracture
Yoon Hae Kwak, Dong Jou Shin, Kun Bo Park
Journal of the Korean Fracture Society.2010; 23(1): 90. CrossRef

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A Study of the Treatments and the Measurements of Carrying Angle on the Supracondylar Fracture of the Humerus in Children: Young Sun Song, Sang Hyeon Yun; J Korean Soc Fract 1997;10(4):956-963. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.956

Abstract PDF

Supracondylar fracture of the humerus is the most common elbow injury in children and adolescents, and it also has many considerable complications. Especially, cubitus varus deformity out of the complications is very unsatisfactory result to the patient in recovery periods in functional and cosmetic viewpoints. Not only nearly or perfect anatomic reduction but aiso accurate measurement of varying angle at the fracture site were necessary to minimize this potential problems. Therefore, the author measured the angles of 250 patients elbow X-ray using Trochlea-Capitellum angle method, a new method of radiological assessment for comparison to carrying angle & Baumanns angle methods. And it appears that this method has statistically less error risk and to be easy to measure angle on X-ray films. Next, the author reports the excellent results of K-wire percutaneous fixation treatment compare to open reduction and internal fixation with statistical siginficance. From the authors retrospective clinical & radiological study of 250 supracondylar fractures, the following results were obtained. 1. Mean differences of the angle between the normal & injured arm were 7.25 in carrying angle, 5.07 in Baumanns angle, and 3.97 in Trochlear-Capitellum angle. 2. K-wire percutaneous fixation group patients stayed in the hospital only average 3.3 days, shorter than average 8.9 days open reduction and internal fixation group. 3. T-test of T-C angles between the K-wire percutaneous fixation and open reduction & internal fixation group show no significant difference. Therefore the former treatment is recommandable. 4. According to the Flynns evaluation, the results of K-wire percutaneous fixation treatment were Excellent in 87 cases(69.1%), Good in 28 cases(22.2%), and Fair in 11 cases(8.7%).

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Reliability of the Radiographic Parameters in Pediatric Supracondylar Fracture
Yoon Hae Kwak, Dong Jou Shin, Kun Bo Park
Journal of the Korean Fracture Society.2010; 23(1): 90. CrossRef

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Change in Carrying Angle after Supraeondylar Fracture of the Humerus in Children: Hyoun Oh Cho, Kyoung Duck Kwak, Sung Do Cho, Byoung Yong Kim; J Korean Soc Fract 1994;7(1):65-71. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.65

Abstract PDF

Supracondylar fracture of the humerus is the most common fracture about the elbow in children. Due to the thinners in this region, it is difficult to reduce the displaced fracture and to maintain the reduction. The purpose of this study is to review the change in carrying angle after this fracture with references to the level and type of the fracture and method of treatment. The authors reviewed 90 cases of supracondylar fracture in children. Ten cases were treated conservatively, sixty eight by percutaneous pinning and twelve by open reduction with regard to the level of the fractures, sixty nine cases(78.9%) revealed fracture through the olecranon fossa. And the less the age of the patient, the more distal was the level of the fracture. change in carrying angle was more common in fractures through the olecranon fossa, in cases of type 4 fractures and in cases of percutaneous pinning. About one third of the cases with fish-tail sign or medial impaction on postoperative roentgenogram showed change in carrying angle of more than 6 degrees. cases with change in carrying angle or more than 6 degrees revealed insufficient redutlon or inadequate fixation. In cases of open reducton the results were good or excellent in all.

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Reliability of the Radiographic Parameters in Pediatric Supracondylar Fracture
Yoon Hae Kwak, Dong Jou Shin, Kun Bo Park
Journal of the Korean Fracture Society.2010; 23(1): 90. CrossRef

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