Calculation of rotational deformity in pediatric supracondylar humerus fractures.
OBJECTIVE
Supracondylar humerus fractures (SCHF) are common in the pediatric population. Cubitus varus deformity (CVD) is the most common long-term complication of SCHFs and may lead to elbow instability and deficits in throwing or extension. Distal fragment malrotation in the axial plane disposes to fragment tilt and CVD; however, no simple method of assessing fracture malrotation exists. This study tested a mathematical method of measuring axial plane malrotation in SCHFs based on plain radiographs.


METHODS
A pediatric SCHF model was made, and x-rays were taken at known intervals of rotation. Five independent, blinded observers measured these films. Calculated rotation for each data set was compared to the known rotation. The identical protocol was performed for an aluminum phantom.


RESULTS
The reliability and agreement of the rotation values were good for both models.


CONCLUSIONS
This method is a reliable, accurate, and cost-effective means of calculating SCHF distal fragment malrotation and warrants clinical application.
Henderson
Eric R
ER
NYU Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003, USA.
Egol
Kenneth A
KA
van Bosse
Harold J P
HJ
Schweitzer
Mark E
ME
Pettrone
Sarah K
SK
Feldman
David S
DS
D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006810:Humeral Fractures / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016916:Joint Deformities, Acquired / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D019047:Phantoms, Imaging; D011859:Radiography; D015203:Reproducibility of Results; D012399:Rotation