Klatt Joshua B, Aoki Stephen K
Department of Orthopaedics, University of Utah, Salt Lake City, UT 84113, USA.
J Pediatr Orthop. 2012 Jul-Aug;32(5):477-82. doi: 10.1097/BPO.0b013e318259ff12.
Medial humeral epicondyle fracture displacement in children is difficult to quantify, as current methods suffer from significant intraobserver and interobserver variability. The aim of this study was to create a systematic approach to determine medial epicondyle fracture displacement based upon easily identifiable radiographic landmarks of the elbow.
In this anatomic descriptive study, we evaluated 171 anteroposterior (AP) and lateral radiographs from children (4 to 15 years old) with a normal distal humerus. On the AP radiograph, the center of the medial epicondyle was compared with a line based upon the inferior olecranon fossa. On the lateral radiograph, the center of the medial epicondyle was compared with the posterior humeral line.
On the AP radiograph, the average location of the center of the medial epicondyle was 0.5 mm inferior to the olecranon line (SD, 2.0 mm). On the lateral radiograph, the average location of the center of the medial epicondyle was 1.2 mm anterior to the posterior humeral line (SD, 1.2 mm).
Our findings demonstrated a consistent radiographic position of the medial humeral epicondyle with little variation throughout skeletal maturation.
This study may be helpful in assessing fracture displacement in pediatric medial epicondyle fractures.
儿童肱骨内上髁骨折的移位情况难以量化，因为目前的方法在观察者内和观察者间存在显著差异。本研究的目的是创建一种基于肘部易于识别的放射学标志来确定肱骨内上髁骨折移位的系统方法。
在这项解剖描述性研究中，我们评估了171例肱骨远端正常的儿童（4至15岁）的前后位（AP）和侧位X线片。在AP X线片上，将内上髁中心与基于鹰嘴窝下方的一条线进行比较。在侧位X线片上，将内上髁中心与肱后线进行比较。
在AP X线片上，内上髁中心的平均位置在鹰嘴线下方0.5毫米处（标准差，2.0毫米）。在侧位X线片上，内上髁中心的平均位置在肱后线前方1.2毫米处（标准差，1.2毫米）。
我们的研究结果表明，在整个骨骼成熟过程中，肱骨内上髁的放射学位置一致，变化很小。
本研究可能有助于评估儿童肱骨内上髁骨折的骨折移位情况。
