Twenty-degree-tilt radiography for evaluation of lateral humeral condylar fracture in children.
OBJECTIVE
To investigate the efficacy of '20 degrees -tilt anteroposterior (A-P) radiography' in the assessment of lateral condylar fractures of the distal humerus.


METHODS
Eighteen children with lateral humeral condylar fractures were studied. Every child underwent conventional A-P and lateral radiography, and six children underwent multi-detector computed tomography (MDCT). For the investigation of 20 degrees -tilt radiography, ten children with lateral humeral condylar fractures had conventional and 20 degrees -tilt A-P and lateral radiography both preoperatively and postoperatively. Fragment dislocation was measured at the lateral and medial margins of the fracture on both the conventional A-P and 20 degrees -tilt A-P radiographs.


RESULTS
The lateral condylar fragment was triangular and was most prominent posteriorly. The fracture line was typically tilted approximately 20 degrees to a reference line perpendicular to the long axis of the humerus in the lateral view. The extent of dislocation at the lateral and medial margins of the fracture site by 20 degrees -tilt A-P radiography (9.3 +/- 3.6 mm and 5.6 +/- 2.5 mm) was significantly wider than that measured by the conventional method (6.8 +/- 4.1 mm and 2.0 +/- 1.5 mm ), which may influence treatment.


CONCLUSIONS
Twenty-degree-tilt A-P radiography may more precisely demonstrate fragment dislocation than standard radiographs and may influence patient treatment.
Department of Orthopedic Surgery, National Hospital Organization, Higashi-Hiroshima Medical Center, 531 Jike, Saijoucho, Higashi Hiroshima, Hiroshima, 739-0041, Japan. imada_hideaki@hiro-hosp.jp
Hideaki
H
Imada
Ryuji
R
Tanaka
Yohei
Y
Itoh
Kazuhiko
K
Kishi
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging*; D006811:Humerus / Q000000981:diagnostic imaging*; D008297:Male; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity