Is radiological rotation measurement affected by the fracture pattern in pediatric supracondylar humeral fractures?
Yavuz Şahbat, Özgür Baysal, Yücel Ağardil, Murat Polat, Ömer Büyüktopçu, Ziya Shammadli, Bülent Erol, Ahmet Hamdi Akgülle- Radiology, Nuclear Medicine and imaging
- General Medicine
- Radiological and Ultrasound Technology
Background
In supracondylar humerus fractures (SCHF), the most frequently used method to calculate rotation is the Gordon lateral rotation percentage (GLRP) defined by Gordon et al. However, this technique includes only typical fractures (49%–80% of all fractures) from the Johns Hopkins (J-H) fracture classification system.
Purpose
The aim of the study was to investigate (1) is Gordon criteria useful for John Hopkins subgroups of supracondylar fractures and (2) is Gordon criteria affected by internal and external rotation.
Material and Methods
This study was designed using four pediatric left humerus bones obtained from the Sawbone© company. For each bone, an osteotomy was made to mimic each of the J-H coronal fracture patterns. The cut bones were placed in a wooden rotation apparatus. The GLRP measurements were taken by five blinded observers.
Results
In the repeated measurements of the observers, <20° rotation typical and <30° medial oblique and lateral oblique fracture pattern were measured as within the limits of an acceptable amount of rotation according to the Gordon criteria. However, for high fracture pattern (HFP), ≤30° internal rotation and <60° external rotation were determined to be within the acceptable rotation criteria according to the Gordon criteria.
Conclusions
All fracture patterns have different characteristics; however, based on the data of this study, the Gordon criteria can be used safely for typical, medial oblique, and lateral oblique fracture patterns but it is necessary to lower the acceptable rate of 50% for HFP.