Background: Computed tomography (CT) provides benefits for 3-dimensional (3D) visualization of femur deformities. However, the potential adverse effects of radiation exposure have become a concern. Consequently, a biplanar imaging system EOS has been proposed to enable reconstruction of the 3D model of the femur. However, this system requires a calibrated apparatus, the cost of which is high, and the area occupied by it is substantial. The purpose of this study was to develop a mobile application that included a new method of 3D reconstruction of the femur from conventional radiographic images and to evaluate the validity and reliability of mobile the application when measuring femoral anteversion. Methods: The statistical shape model, graph-cut algorithm, and iterative Perspective-n-Point algorithm were utilized to develop the application. The anteroposterior and lateral images of a femur can be input using the embedded camera or by file transfer, and the touch interface aids accurate contouring of the femur. Regarding validation, the CT scans and conventional radiographic images of 36 patients with cerebral palsy were used. To evaluate concurrent validity, the femoral anteversion measurements on the images reconstructed from the mobile application were compared with those from the 3D CT images. Three clinicians assessed interobserver reliability. Results: The mobile application, which reconstructs the 3D image from conventional radiographs, was successfully developed. Regarding concurrent validity, the correlation coefficient between femoral anteversion measured using 3D CT and the mobile application was 0.968 (P<0.001). In terms of interobserver reliability, the intraclass correlation coefficient among the 3 clinicians was 0.953. Conclusions: The measurement of femoral anteversion with the mobile application showed excellent concurrent validity and reliability in patients with cerebral palsy. The proposed mobile application can be used with conventional radiographs and does not require additional apparatus. It can be used as a convenient technique in hospitals that cannot afford a CT machine or an EOS system. Level of Evidence: Level III—diagnostic.
Introduction: Supracondylar humerus (SCH) fracture is the most common type of elbow joint fracture (50–70%) in children aged 3–10 years. Treatment of displaced SCH fracture are surgery using Kirschner wire. The outcome of SCH fracture in pediatric population can be assessed clinically and radiologically. Methods: This study aims to analyze the correlation between radiological alignment and functional outcome in displaced SCH fracture in children under internal fixation. Study design was cross sectional with analytical approach. Medical records of children with displaced SCH fracture from January 2016 to December 2018 were taken for the study. The data included in this study were at six weeks after removal of implant. The parameter of radiological alignment used in this study was Baumann's angle and the functional outcome based on Flynn's criteria. Data were analyzed using the Pearson Correlation test. Results: Of the thirty samples enrolled in this study, 63.3% were boys. The mean age was 6.4 ± 2.0 years with peak incidence 5–6 years. Left side and non-dominant arm were more commonly injured with percentage of 63.3% and 70%. The mean of Baumann's angle and functional outcome were 73.5 ± 7.18 and 6.44 ± 4.7 degrees, respectively. There was a significant positive Pearson correlation (r = 0.491) between radiological alignment and functional outcome (p value = 0.006). Conclusion: Radiological alignment had a significant positive correlation with functional outcome after surgery in displaced SCH patients. Highlights:
Highlights Complete laceration of the radial nerve following supracondylar humerus fracture is a rare finding. Radial nerve injury with wrist-drop is seen two weeks after the injury. The sensory disturbance is shown as anaesthesia in the radial nerve distribution. Neurorrhapy was done in conjunction with the open reduction internal fixation of the fracture.
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