Md. Mehedi Newaz¹*, Md Sahedur Rahman², Tanveer Hasan³, Yunus Uzzaman Khan⁴, Jyotirmoy Sarkar⁵, Moloy Mollick⁶ and Shibendu Mistry⁷

¹Associate Professor, Department of Orthopedic Surgery, Khulna Medical College, Bangladesh
²Registrar, Department of Paediatric Orthopaedic Surgery, Khulna Medical College Hospital, Khulna, Bangladesh
³Assistant Registrar, Department of Paediatric Orthopaedic Surgery, Khulna Medical College Hospital, Khulna, Bangladesh
⁴Assistant Registrar, Department of Orthopaedics, Khulna Medical College Hospital, Khulna, Bangladesh
⁵Medical Officer, Department of Orthopaedics, Khulna Medical College Hospital, Khulna, Bangladesh
⁶Medical Officer, Department of Orthopaedics, Khulna Medical College Hospital, Khulna, Bangladesh
⁷Residential Surgeon, Dept of Orthopaedics, Khulna Medical College Hospital, Khulna, Bangladesh

*Corresponding Author: Md. Mehedi Newaz, Associate Professor, Department of Orthopedic Surgery, Khulna Medical College, Bangladesh.

Received: August 14, 2023; Published: September 04, 2023

Abstract

Background: Baumann’s angle is an important radiographic tool used in the assessment of the quality of reduction of humeral supracondylar fractures in children. It plays a vital role in the prevention of varus malunion in these fractures by providing a good estimate of the carrying angle of the elbow.

Objective: To assess the relationship between Baumann’s angle and the trochleao capitellar index in pediatric elbows.

Methods: The retrospective-prospective study was carried out at the Department of Orthopedic Surgery, Private Clinics at Khulna, Bangladesh from March 2018 to February 2023. Total of 45 children were analyzed under 14 years of age with supracondylar humerus fractures. They were analyzed by X-ray anteroposterior view of injured elbow, made before and after the surgery, by measuring Bauman’s angle. Clinical examination was performed after completing physical therapy, when was measured carrying angle of the injured and healthy elbow using a goniometer. Results: A mean value of Baumann’s angle of 72.4o was determined with a reference interval of 64o to 80o. The mean trochlea capitellar index was found to be 0.48 with a reference interval of 0.25 to 0.85. Baumann’s angle and the trochlea capitellar index did not vary with age or sex. The trochlea capitellar index was found to positively correlate with Baumann’s angle. The correlation coefficient and the coefficient of determination values for the linear relationship between the two measurements were 0.589 and 0.347 respectively.

Conclusion: We concluded that Baumann’s angle and the trochlea capitellar index do not vary with age, sex, or race. There is a positive correlation between Baumann’s angle and the trochlea capitellar index. Further studies on the role of the trochlea capitellar index in the assessment of the final carrying angle of pediatric elbows need to be conducted.

Keywords: Humeral Supracondylar Fracture; Trochlea Capitellar Angle; Baumann’s Angle; Carrying Angle

References

1. Worlock P. “Supracondylar Fractures of the Humerus: Assessment of Cubitus Varus by the Baumann Angle”. The Journal of Bone and Joint Surgery. British volume (1986): 568-B, 755-757.
2. Williamson DM., et al. “Normal characteristics of the Baumann (humerocapitellar) angle: an aid in assessment of supracondylar fractures”. Journal of Pediatric Orthopedics5 (1992): 636-639.
3. Cheng JC., et al. “Closed reduction and percutaneous pinning for type III displaced supracondylar fractures of the humerus in children”. Journal of Orthopaedic Trauma 9 (1995): 511-515.
4. Omid R., et al. “Supracondylar humeral fractures in children”. The Journal of Bone and Joint Surgery. American Volume 90 (2008): 1121-1132.
5. Otsuka NY and Kasser JR. “Supracondylar fractures of the humerus in children”. Journal of the American Academy of Orthopaedic Surgeons 5 (1997): 19-26.
6. Camp J., et al. “Alteration of Baumann’s angle by humeral position: implications for treatment of supracondylar humerus fractures”. Journal of Pediatric Orthopaedics 13 (1993): 521-525.
7. Acton JD and McNally MA. “Baumann’s confusing legacy”. Injury 32 (2001): 41-43.
8. Gorelick L., et al. “Assessment of the normal and pathological alignment of the elbow in children using the trochleocapitellar index”. BMC Musculoskeletal Disorders1 (2014): 60.
9. Grayson D E. “The Elbow : Radiographic Imaging Pearls and Pitfalls”. Seminar on Roentgenology3 (2005): 223-247.
10. Keenan WN and Clegg J. “Variation of Baumann’s angle with age, sex, and side: implications for its use in radiological monitoring of supracondylar fracture of the humerus in children”. Journal of Pediatric Orthopaedics 16 (1996): 97-98.
11. Silva M., et al. “Inter- and intra-observer reliability of the Baumann angle of the humerus in children with supracondylar humeral fractures”. International Orthopaedics 34 (2010): 553-557.
12. Worlock P. “Supracondylar fractures of the humerus. Assessment of cubitus varus by the Baumann angle”. The Journal of Bone and Joint Surgery. British volume 68 (1986): 755-757.

Citation

Citation: Md. Mehedi Newaz., et al. “Relationship Between Baumann's Angle and the Trochleocapitellar Index in Pediatric Supracondylar Fracture of Elbow". Acta Scientific Orthopaedics 6.10 (2023): 03-06.

Copyright

Copyright: © 2023 Md. Mehedi Newaz., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.