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. 2019 Jul-Aug;10(4):792-796.
doi: 10.1016/j.jcot.2018.07.019. Epub 2018 Jul 23.

Pediatric elbow measurement parameters: Evaluation of the six angles in inter- and intra-observer reliability

Purinon Suangyanon  1 , Ornusa Chalayon  1 , Kitti Worawuthangkul  1 , Kamolporn Kaewpornsawan  1 , Thanase Ariyawatkul  1 , Perajit Eamsobhana  2
Affiliations

Pediatric elbow measurement parameters: Evaluation of the six angles in inter- and intra-observer reliability

Purinon Suangyanon et al. J Clin Orthop Trauma. 2019 Jul-Aug.

Abstract

Background: Several radiographic measurements of the humerus can be used to evaluate the treatment outcome of supracondylar fractures in children. Because of the cartilaginous nature of the immature elbow, interpretation of radiographs around this area is sometimes challenging and can be unreliable. This study was conducted to determine the inter-observer and intra-observer reliability of the six commonly used radiographic measurements of the distal humerus.

Method: The Baumann angle, humero-ulna angle, metaphyseal-diaphyseal angle, radial epiphyseal angle, shaft-condylar angle and lateral capitellohumeral angle of the humerus were measured by two observers on the radiographs of uninjured elbows from 58 children. The values between each measurement were compared and correlated using a Pearson coefficient of correlation to determine the inter-observer and intra-observer reliability.

Results: All of the radiographic parameters showed excellent intra-observer reliability with the correlation coefficient values of the Baumann angle, humero-ulna angle, metaphyseal-diaphyseal angle, radial epiphyseal angle, shaft-condylar angle, lateral capitellohumeral angle as 0.945, 0.95, 0.909, 0.888, 0.961 and 0.975 (p < 0.001), respectively. The inter-observer reliability of the Baumann and humero-ulna angles were also found to be highly correlated at r = 0.843 (p < 0.001) and 0.878 (p < 0.001), respectively. The metaphyseal-diaphyseal angle had poor reliability with r = 0.136 (p = 0.291) while the radial epiphyseal angle, shaft-condylar angle, and lateral capitellohumeral angle demonstrated good reliability with r = 0.675 (p < 0.001), 0.747 (p < 0.001), and 0.686 (p < 0.001), respectively.

Conclusion: The Baumann angle and humero-ulna angle measurements of distal humerus showed excellent inter- and intra-observer reliability. Both parameters represent repeatable and reliable methods for determining the outcome of supracondylar humeral fractures in pediatric population.

Keywords: Baumann angle; Humero-ulna angle; Lateral capitellohumeral angle; Metaphyseal-diaphyseal angle; Radial-epiphyseal angle; Shaft-condylar angle.

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Figures

Fig. 1
Fig. 1
A: Baumann angle, 1 B: humero-ulnar angle (HUA), 1C: Metaphyseal-diaphyseal angle (MDA), 1D: radial epiphyseal angle (REA), 1 E: shaft condylar angle (SCA), 1 F: lateral capitellohumeral angle (LCHA).
Fig. 2
Fig. 2
Inter and intra observer reliability of six radiographic parameters.
Fig. 2
Fig. 2
Inter and intra observer reliability of six radiographic parameters.
See this image and copyright information in PMC

References

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