Abstract
BackgroundDistal humerus fractures (DHFs) constitute one-third of elbow fractures approximately. In this study, we aim to define and analyze the fracture lines and morphological features of DHFs using mapping technique.MethodsOne hundred and two DHFs were retrospectively reviewed. All the computed tomography (CT) data were used to manually reconstruct and virtually reduce the DHF fragments to fit a standard 3D model. Smooth curves were depicted accurately onto the surface of the template to represent the fracture lines. All the curves were overlapped onto the model to create the 3D fracture map and heat map.ResultsOur analysis was based on 102 CT images of DHFs, contributed by 59 male and 43 female patients (mean age, 46 years; range, 18-93 years), and included 15 type A, 25 type B, and 62 type C fractures. On mapping, the hot zones were located in the radial fossa, coronoid fossa, olecranon fossa, and the external part of the trochlear. Conversely, the cold zones were noted in medial condyle, the medial side of the trochlear, and the anterolateral area on the supracondylar ridge.ConclusionsOur study firstly shows the fracture lines and morphological features of distal humeral fractures by three-dimensional mapping technology. Distal humerus fracture lines are characteristic and highly related to the micro-architecture difference of distal humerus, which may provide some guidance for the treatment plan selection and surgical fixation design.
Highlights
Distal humerus fractures (DHFs) constitute a significant proportion of elbow injuries, which are complex injuries around the elbow caused by high- or low-energy trauma
Heat mapping On the heat map (Fig. 3), the hot zones were located in the radial fossa, coronoid fossa, olecranon fossa, the lateral side of the capitellum, and the external part of the trochlear
Due to the increasing focus on big data analysis, 3D computed tomography (CT)-based fracture mapping has been widely used in the field of orthopedics, such as the fracture characterization of proximal femur [8], tibial plateau [11, 12], distal radius [13], or patellar [14], as originally described by Cole et al [6]
Summary
Distal humerus fractures (DHFs) constitute a significant proportion of elbow injuries, which are complex injuries around the elbow caused by high- or low-energy trauma. As the latest AO/OTA classification which introduced the use of axial CT views to further describe the location of articular depression, is the most commonly used clinical classification method, it divides DHFs into extra-articular (13A), partial articular (13B), and complete articular (13C) types [3]. These types, and their subtypes, describe fracture patterns, stability, and predict prognosis. We aim to define and analyze the fracture lines and morphological features of DHFs using mapping technique
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