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Paediatric upper limb trauma
Published in Sebastian Dawson-Bowling, Pramod Achan, Timothy Briggs, Manoj Ramachandran, Stephen Key, Daud Chou, Orthopaedic Trauma, 2014
Chethan Jayadev, Tanvir Khan, Manoj Ramachandran
The following radiographic features help in assessing distal humeral injuries: Anterior humeral line – the capitellum is angulated 30–40° anteriorly to the long axis of the humerus. A line following the anterior humeral cortex should pass through the middle third of the capitellum. However, this can be variable in very young children.Radiocapitellar line – a line through the radial neck should intersect the capitellum on all views.Baumann’s angle – Baumann actually described two angles (Fig. 24.3), which resulted in much confusion: The angle formed by the long axis of the humerus and a line through the physis of the lateral condyle/capitellum (α). Baumann used this ‘shaft-physis’ angle to assess reduction.The angle formed by a line through the capitellum/lateral condyle physis and a line perpendicular to the long axis of the humerus (90-α).
Injuries of the Shoulder, Upper Arm and Elbow
Published in Louis Solomon, David Warwick, Selvadurai Nayagam, Apley and Solomon's Concise System of Orthopaedics and Trauma, 2014
Louis Solomon, David Warwick, Selvadurai Nayagam
The anteroposterior x-ray is often difficult to interpret because it is taken with the elbow flexed. The degree of sideways tilt (angulation) may therefore not be appreciated. This is where Baumann’s angle is most helpful; wherever possible it should be accurately measured and compared with that of the uninjured side (Figure 26.14).
9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children
Published in Acta Orthopaedica, 2018
Noora Tuomilehto, Antti Sommarhem, Aarno Y Nietosvaara
Quality of reduction has traditionally been assessed by radiographs. Frontal alignment can be evaluated by measuring the Baumann angle (BA), which is the angle between the long axis of the humeral shaft and the growth plate of the lateral humeral condyle with reported normal values between 64° and 81° (Williamson et al. 1992, Dai 1999, Shank et al. 2011, Flynn et al. 2015). The most common way to register sagittal alignment is to record whether the anterior humeral line (AHL) passes through the anterior or middle third of the ossification center of the capitulum (Herman et al. 2009, Flynn et al. 2015). Reliability of these radiographic indexes has been questioned (Silva et al. 2010), and it has been suggested that it is better to record the quality of reduction peroperatively by clinical comparison with the healthy side (Simanovsky et al. 2007, Tuomilehto et al. 2016).
Evaluation of A Better Approach for Open Reduction Of Severe Gartland Type III Supracondylar Humeral Fracture
Published in Journal of Investigative Surgery, 2021
At the final visit, all patients were evaluated functionally and radiologically. The carrying angle and range of motion of the operated side were compared with those of the normal elbow. The Baumann angle was evaluated in the coronal plane. We classified the surgical outcomes by the Flynn criteria as follows [10]: excellent, the elbow joint can be normally flexed and extended, with a carrying angle of 10°–15°; good, the elbow joint flexion is reduced by 5°, with a decreased carrying angle or cubitus varus of 0°–5°; fair, the elbow joint flexion is reduced by 0°–10°, with a cubitus varus of 6°–10°; and poor, the elbow joint flexion is reduced by >5°, with a cubitus varus of 11°–15°.
Supracondylar Humerus Fractures in Infants and Early Toddlers; Characteristics, Clinical and Radiological Outcomes Compared with Older Children
Published in Journal of Investigative Surgery, 2022
Ahmet Hamdi Akgülle, Yavuz Şahbat, Özgür Baysal, Hayati Kart, Bülent Erol
The current study evaluations used the Baumann angle and lateral translation on anteroposterior view, the anterior humeral line crossing the capitellum, and the Gordon rotation percentage on lateral view X-Rays [30]. These measurements were made with radiographs from the early postoperative period, but Gordon rotation percentage measurements could not be performed again in follow-up after pin removal because of callus formation, especially in patients with higher percentages. Although numerous studies have used this parameter, it was not possible to make consistent measurements for the reason noted here and therefore this variable was removed from the statistical analysis.