A 3-Dimensional Analysis of the Fracture Planes in Pediatric Lateral Humeral Condyle Fractures for Image-Based Pin Positioning During Fixation
OBJECTIVE: To determine the 3-dimensional morphology of pediatric lateral condylar physeal fractures using 3-dimensional computed tomography (3D-CT) and to identify optimal pin positions for percutaneous pinning.
DESIGN: Prospective case series of consecutively treated patients.
SETTING: Tertiary university hospital setting.
PATIENTS: Preoperative 3D-CTs in pediatric surgical candidates diagnosed with lateral condylar physeal fractures.
INTERVENTION: Closed reduction and percutaneous pinning was performed.
MAIN OUTCOME MEASURES: Reconstructed images of the distal humerus were aligned accordingly to determine the coronal (α), sagittal (β), and axial tilt (γ) angles of the fracture plane. Both α and β were also measured on plain radiography. Image-based position of the 2 pins was calculated preoperatively using 3D-CT, based on anteroposterior and lateral views. Final angle of pins was measured on postoperative radiographs.
RESULTS: A total of 29 fractures were assessed. 3D-CT reconstruction images of fractures showed a posterolateral fracture fragment with reference to the long axis of the humerus. The mean α, β, and γ were 62 degrees [95% confidence interval (CI), 59-64], 69 degrees (95% CI, 65-72), and 36 degrees (95% CI, 34-38). Both α and β measured on plain radiography were not significantly different from 3D-CT measurements (P = 0.6712, 0.6218). Average postoperative pin angles were 144 degrees (95% CI, 140-147) and 161 degrees (95% CI, 158-165) for the proximal pin, and 118 degrees (95% CI, 114-122) and 115 degrees (95% CI, 110-120) for the distal pin, on anteroposterior and lateral views, respectively, resulting in similar trajectories to the preoperatively calculated pin positions.
CONCLUSION: Our study adds to the current knowledge by providing an image-based angular reference of the fracture configuration in pediatric lateral humeral condyle fractures, which may be used during percutaneous pinning.
LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
Journal of orthopaedic trauma - 31(2017), 10 vom: 05. Okt., Seite e340-e346 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Park, Do Young [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 16.07.2018 Date Revised 16.07.2018 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/BOT.0000000000000914 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM272200875 |
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| 100 | 1 | |a Park, Do Young |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A 3-Dimensional Analysis of the Fracture Planes in Pediatric Lateral Humeral Condyle Fractures for Image-Based Pin Positioning During Fixation |
| 264 | 1 | |c 2017 | |
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| 500 | |a Date Completed 16.07.2018 | ||
| 500 | |a Date Revised 16.07.2018 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To determine the 3-dimensional morphology of pediatric lateral condylar physeal fractures using 3-dimensional computed tomography (3D-CT) and to identify optimal pin positions for percutaneous pinning | ||
| 520 | |a DESIGN: Prospective case series of consecutively treated patients | ||
| 520 | |a SETTING: Tertiary university hospital setting | ||
| 520 | |a PATIENTS: Preoperative 3D-CTs in pediatric surgical candidates diagnosed with lateral condylar physeal fractures | ||
| 520 | |a INTERVENTION: Closed reduction and percutaneous pinning was performed | ||
| 520 | |a MAIN OUTCOME MEASURES: Reconstructed images of the distal humerus were aligned accordingly to determine the coronal (α), sagittal (β), and axial tilt (γ) angles of the fracture plane. Both α and β were also measured on plain radiography. Image-based position of the 2 pins was calculated preoperatively using 3D-CT, based on anteroposterior and lateral views. Final angle of pins was measured on postoperative radiographs | ||
| 520 | |a RESULTS: A total of 29 fractures were assessed. 3D-CT reconstruction images of fractures showed a posterolateral fracture fragment with reference to the long axis of the humerus. The mean α, β, and γ were 62 degrees [95% confidence interval (CI), 59-64], 69 degrees (95% CI, 65-72), and 36 degrees (95% CI, 34-38). Both α and β measured on plain radiography were not significantly different from 3D-CT measurements (P = 0.6712, 0.6218). Average postoperative pin angles were 144 degrees (95% CI, 140-147) and 161 degrees (95% CI, 158-165) for the proximal pin, and 118 degrees (95% CI, 114-122) and 115 degrees (95% CI, 110-120) for the distal pin, on anteroposterior and lateral views, respectively, resulting in similar trajectories to the preoperatively calculated pin positions | ||
| 520 | |a CONCLUSION: Our study adds to the current knowledge by providing an image-based angular reference of the fracture configuration in pediatric lateral humeral condyle fractures, which may be used during percutaneous pinning | ||
| 520 | |a LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Cho, Jae Ho |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Doo-Hyung |e verfasserin |4 aut | |
| 700 | 1 | |a Choi, Wan-Sun |e verfasserin |4 aut | |
| 700 | 1 | |a Bang, Jun Young |e verfasserin |4 aut | |
| 700 | 1 | |a Yin, Xiang Yun |e verfasserin |4 aut | |
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