Radiographic Circularity of Capitellum and Its Relation to the Range of Motion

Abstract

Background: The shape of the capitellum has been traditionally described in anatomy books as part of a sphere. Alteration in the capitellar morphology following pathologies such as fractures, osteochondrosis, and degenerative arthritis has been associated with less optimum functional results. Aim: To define the relationship between the sphericity of the capitellar morphology as measured on trauma series plain radiographs and the elbow range of motion. Methods: 40 patients were included in the study. All patients recruited from the upper limb clinics presented with non-elbow joint-related complaints. The elbow range of motion was measured using a standardized technique. Digital anteroposterior and lateral radiographs of patients' elbows were used to measure capitellar circularity using the ImageJ processing program and circularity calculation equation. Correlation analyses were conducted between the degree of capitellar sphericity and elbow range of motion. Results: The results of measurements from the anteroposterior radiographs showed a positive correlation between increased circularity and an increase in the range of flexion, pronation, and supination. The range of extension decreased with the increased circularity of the capitellum. This trend was repeated with measures of lateral radiographs but was statistically not significant. Conclusion: Native capitellar circularity has an impact on the elbow range of motion. This should be put into consideration when dealing with pathologies that affect capitellar morphology.