Abstract
Sagittal Plane Malalignment in Paediatric Supracondylar Fractures of the Distal Humerus: A Review of the Literature
Highlights
Supracondylar fractures of the distal humerus constitute 3.3-17.9%[1,2] of all paediatric fractures and 58% of elbow fractures in children[3]
Rogers et al[30] first described the anterior humeral line (AHL) in 1978 as a line drawn on the lateral radiograph along the anterior humeral cortex which distally bisects the middle third of the capitellar ossification centre (Figure 2)
As the capitellar ossification centre, which normally appears between six months and two years, progressively increases in size until it reaches its adult configuration between ten and twelve years, the AHL may bisect it at different points depending on the age of the child making its use somewhat difficult
Summary
Supracondylar fractures of the distal humerus constitute 3.3-17.9%[1,2] of all paediatric fractures and 58% of elbow fractures in children[3]. A type IV pattern has been proposed[7], which in addition to complete loss of cortical contact, describes instability in flexion and extension as assessed intra-operatively or under image guidance and may prove useful for operative decision making. This classification system has better reliability than other commonly used classification systems[8], several studies have highlighted its poor inter-observer reproducibility and advocate examining the absolute degree of radiographic displacement when deciding how to manage these injuries[9,10].
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