Assessment of Lateral Rotation Percentage and Rotational Deformity of the Elbow in Type 3 Supracondylar Humerus Fractures: A Biomechanical Study

Rehm, Andreas; Thahir, Azeem; Ashby, Eric; Novak, Pinelopi Linardatou

doi:10.1097/bpo.0000000000002280

Cited by 1 publication

(2 citation statements)

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“…15 Although it was criticized later, the model study of Berdis et al has clinical justification. 16 Moreover, the observers in the current study found the highest mean measurement values in the high fracture pattern (Table 1), which could be attributed to the anatomic differences in this region from other subtypes.…”

Section: Discussionmentioning

confidence: 46%

“…In a Sawbone model study, Berdis et al stated that the region where the high fracture pattern occurs has different characteristics, which is the more narrow and cylindrical nature of the proximal metaphysis compared with fractures at the level of the flare of the medial and lateral condyles 15 . Although it was criticized later, the model study of Berdis et al has clinical justification 16 . Moreover, the observers in the current study found the highest mean measurement values in the high fracture pattern (Table 1), which could be attributed to the anatomic differences in this region from other subtypes.…”

Section: Discussionmentioning

confidence: 99%

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Reliability of Gordon Lateral Rotation Percentage and Prabhakar Percentage of Metaphyseal Overhang for Pediatric Supracondylar Humerus Fracture; Is it Clinically Reliable for John Hopkins Classification Coronal Fracture Subtypes?

Şahbat,

Bekiroğlu,

Çat

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Rotational malalignment is a common problem in pediatric supracondylar humerus fractures (SCHF). Several techniques have been described to evaluate the true rotation value. Although the Prabhakar and Gordon techniques are used frequently, their superiority to each other in terms of measurement quality is unknown. Questions/Purposes: The aim of this study was to investigate the clinical compatibility of the 2 techniques and to evaluate whether they are suitable for all subtypes. Methods: This cross-sectional study included 40 patients with SCHF (including subtypes; Typical, Medial Oblique, Lateral Oblique, and High fracture pattern). The Gordon lateral rotation percentage and Prabhakar percentage of metaphyseal overhang were measured twice by 4 experienced Orthopedics and Traumatology surgeons at 8-week intervals. The interobserver and intraobserver reliability were examined using the intraclass correlation coefficient. Results: The interobserver reliability for Gordon and Prabhakar technique was 0.816 and 0.762 for the first measurement and 0.811 and 0.811 for the second measurement, respectively. The medial oblique fracture pattern was determined to have the best interobserver agreement among the subtypes. The result was excellent for the medial and lateral oblique subtypes, good for the typical fracture pattern, and fair for the high fracture pattern. The intraobserver reliability for Gordon and Prabhakar technique was excellent, 0.924 and 0.922, respectively. Conclusion: The main finding of this study was that the Gordon and Prabhakar techniques have similar interobserver and intraobserver reliability. Although the Gordon technique tends to have higher interobserver reliability, the difference was clinically insignificant. These measurements should not be relied upon in cases of SCHF with a high fracture pattern because of the different anatomic features of that region. Level of Evidence: Level III.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%