Three-dimensional analysis of cubitus varus deformity after supracondylar fractures of the humerus. 2011

Yukari Takeyasu, and Tsuyoshi Murase, and Junichi Miyake, and Kunihiro Oka, and Sayuri Arimitsu, and Hisao Moritomo, and Kazuomi Sugamoto, and Hideki Yoshikawa
Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.

BACKGROUND What is thought of as a classic "cubitus varus" deformity usually consists of varus, extension, and internal rotation. However, its 3-dimensional (3D) pattern with 3D imaging has not been reported. This study aimed to obtain such 3D patterns using 3D bone models created from computed tomography data and evaluate the accuracy of conventional radiographic and clinical methods of assessing the deformity. METHODS Imaging of 25 humeri of 25 patients with cubitus varus deformity caused by previous humeral supracondylar fractures was performed. The deformity was assessed by superimposing the 3D bone model onto a mirror-image model of the contralateral normal humerus. The 3D deformity pattern of cubitus varus was evaluated based on the 3 deformity components. Values obtained from conventional radiographic and physical measurements--that is, humerus-elbow-wrist angle (HEW-A), tilting angle (TA), maximal elbow flexion angle (MEF), and internal rotation angle (IRA)--were compared with those from the 3D technique. RESULTS Of the patients, 44% had varus, extension, and rotation deformities of 10° or greater; 20% had varus and extension deformities of 10° or greater; 16% had varus and internal rotation deformities of 10° or greater; and 20% had varus deformity only. When the 3D measurements were considered accurate, an error of 10° or greater was found in 8%, 24%, 8%, and 44% of cases in terms of HEW-A, TA, MEF, and IRA values, respectively. CONCLUSIONS Of the humeri, 80% had other bony deformities in addition to varus and 20% had isolated varus deformities. HEW-A and MEF showed reasonable accuracy as measures for the degree of deformity, whereas TA and IRA were found to be relatively inaccurate.

UI MeSH Term Description Entries
D008297 Male Males
D010808 Physical Examination Systematic and thorough inspection of the patient for physical signs of disease or abnormality. Physical Exam,Examination, Physical,Physical Examinations and Diagnoses,Exam, Physical,Examinations, Physical,Exams, Physical,Physical Examinations,Physical Exams
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004551 Elbow Joint A hinge joint connecting the FOREARM to the ARM. Elbow Joints,Joint, Elbow,Joints, Elbow
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006810 Humeral Fractures Fractures of the HUMERUS. Humeri Fractures,Humerus Fractures,Fracture, Humeral,Fracture, Humeri,Fracture, Humerus,Humeral Fracture,Humeri Fracture,Humerus Fracture
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths

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