TITLE

Relationship of the Anterior Humeral Line to the Capitellar Ossific Nucleus: Variability with Age

AUTHOR(S)
Herman, Martin J.; Boardman, Matthew J.; Hoover, Justin R.; Chafetz, Ross S.
PUB. DATE
September 2009
SOURCE
Journal of Bone & Joint Surgery, American Volume;Sep2009, Vol. 91-A Issue 9, p2188
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: The anterior humeral line is used to assess displacement and the adequacy of reduction of supracondylar humeral fractures in children. It is said to pass through the middle third of the capitellum in the elbow of a normal child. Few reports in the published literature have discussed this measurement, and the intra-rater and inter-rater reliability of the measurement is not known. The purposes of the present study were to define the position of the anterior humeral line in normal, skeletally immature elbows and to determine the intra-rater and inter-rater reliability of this parameter. Methods: On two occasions, three observers (a pediatric orthopaedic surgeon, a senior orthopaedic resident, and a senior medical student) recorded the location of the anterior humeral line as it passed through the capitellum as seen on the lateral radiographs of thirty normal elbows in children ranging in age from four months to three years and eleven months and thirty normal elbows in children ranging in age from four to nine years. For these measurements, the capitellum was divided into three regions: the anterior third, the middle third, and the posterior third. All observers received written instructions, and identical rulers were used to make the measurements. Results: Each observer made 120 measurements. Overall, the anterior humeral line passed through the anterior third of the capitellum in 31% of the elbows, the middle third in 52%, and the posterior third in 18%. In children younger than four years of age, the line passed nearly equally through either the anterior or middle third of the capitellum. In older children, the anterior humeral line passed through the middle third in 62% of the elbows. Overall, intra-rater reliability and inter-rater reliability were moderate to substantial. Conclusions: The anterior humeral line passes through the middle third of the capitellum in the majority of normal children. In children younger than four years of age, it passes nearly equally through the anterior or middle third of the capitellum, whereas in older children it more consistently passes through the middle third of the capitellum. The surgeon must be aware of the variability of the location of the anterior humeral line with age when utilizing it to assess radiographs of the elbow in children after an injury or after the reduction of a displaced supracondylar fracture.
ACCESSION #
44137373

 

Related Articles

  • Chapter 18: Orthopaedic trauma.  // Surgical Care at the District Hospital;1/1/2002, p18 

    Chapter 18 of the book "Surgical Care at the District Hospital" is presented. It explores the correct procedures in the management of orthopedic trauma. Included procedures are for clavicle fractures, acromial-clavicular joint separation and humeral shaft fractures. The management of fracture...

  • CORR Insights: Cosmetic Lower Limb Lengthening by Ilizarov Apparatus: What are the Risks? Reinker, Kent // Clinical Orthopaedics & Related Research;Nov2014, Vol. 472 Issue 11, p3557 

    The author discusses the complications experience by the patients of lower limb lengthening surgery including osteomyelitis, knee subluxations, and deformed regenate. Topics mention the responsibility of orthopedic surgeon before the surgery including the information on the risk and benefits of...

  • Does time to surgery matter for type 2 supracondylar humerus fractures? Porucznik, Mary Ann // AAOS Now;Jun2011, Vol. 5 Issue 6, p15 

    The article focuses on the result of a study which examines whether a delay in surgical treatment for type 2 supracondylar humerus fractures in children would have an impact on outcomes. The study analyzes 399 supracondylar fractures which were treated surgically at a tertiary referral center in...

  • Intraobserver and Interobserver Agreement in the Measurement of Displaced Humeral Medial Epicondyle Fractures in Children. Pappas, Nick; Lawrence, John T.; Donegan, Derek; Ganley, Ted; Flynn, John M. // Journal of Bone & Joint Surgery, American Volume;Feb2010, Vol. 92-A Issue 2, p322 

    Background: Fractures of the humeral medial epicondyle occur frequently in children. The decision to pursue operative or nonoperative treatment often hinges on the amount of perceived fracture displacement. This study was performed to assess both intraobserver and interobserver agreement in the...

  • Análisis comparativo del enclavijamiento de las fracturas supracondíleas de húmero en niños. Díaz-Borjón, Efraín; Del Campo Sánchez, Antonio Martínez; Valle-de Lascurain, Gerardo; Guzmán-Robles, Oscar // Acta Ortopedica Mexicana;nov/dic2003, Vol. 17 Issue 6, p298 

    Introduction: Displaced supracondylar fractures of the humerus in children are frequently treated surgically with percutaneous pin fixation using Kirschner wires. Controversy has aroused from the two most frequent modalities, crossed-pinning vs lateral pinning because of nerve injury in the...

  • The Epidemiology and Spectrum of Surgical Care in District Hospitals of Pakistan. Blanchard, Robert J. W.; Blanchard, Madeline E.E.; Toussignant, Pierre; Ahmed, Mushtaq; Smythe, Cheves M. // American Journal of Public Health;Nov87, Vol. 77 Issue 11, p1439 

    Abstract: On-site surveys of 19 district-level hospitals in Pakistan revealed that, in 1983.23,839 procedures were performed. There were 98 different types of operations. Thirty-eight percent were classified as General Surgery. 30% Gynecology and Operative Obstetrics. 19% Urology. and 13%...

  • Bilateral Humerus and Corner Fractures in an 18-Month-Old Infant. Kaplan, Kevin M.; Gruson, Konrad I.; Paksima, Nadir // Bulletin of the NYU Hospital for Joint Diseases;2008, Vol. 66 Issue 2, p124 

    Child abuse continues to be a serious problem that is likely to be encountered in all medical specialties, with orthopaedic surgeons commonly evaluating children having sustained musculoskeletal injuries. In busy emergency departments and clinics, junior residents shoulder much of the...

  • CLOSE REDUCTION AND PER CUTANEOUS PINNING OF SUPRACONDYLAR FRACTURES OF HUMERUS IN CHILDREN. Sohail Iqbal; Maqbool, Nouman; Basit, Abdul; Awais Ahmed; Sheikh, Saba Sohail; Sohail, Muhammad Imran; Sheikh, Zara Sohail // Pakistan Armed Forces Medical Journal;Mar2014, Vol. 64 Issue 1, p29 

    Objective: The purpose of this study was to assess outcome and complications associated with closed reduction and internal fixation of supracondylar fractures type III of humerus in children. Study Design: Quasi - experimental. Place and Duration of Study: Department of Orthopedics, Fauji...

  • Management of Grossly Displaced Paediatric Supracondylar Humeral Fractures with Delayed Presentation by Closed Reduction and Percutaneous Pinning. Kiran, Kopuri Ravi; Babu, S. Suresh; Babu, T. V. Suresh; Deepti, K. // British Journal of Medicine & Medical Research;2015, Vol. 5 Issue 2, p254 

    Background: Management guidelines are not yet clear for these patients who present late with displaced supracondylar fracture. The aim of this prospective study was to evaluate the clinical, radiological and functional outcome following closed reduction and percutaneous pinning of widely...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics