Does using the medial or lateral humeral line improve reliability of Baumann angle measurement on plain x-ray? The effect of humeral length visualized on the x-ray

Journal of Pediatric Orthopedics
Walter F KrengelGregory A Schmale

Abstract

Baumann angle (BA) is a common measure of coronal plane alignment of the distal humerus. We hypothesize that the reliability of measuring BA would be improved by using the medial and lateral cortical margins of the humerus seen on plain x-ray, rather than the estimated central humeral line, which is the "standard" technique. Further, we analyze whether the amount of humerus visible on the film improves the reliability of the method. A total of 71 anteroposterior elbow digital radiographs from patients aged 0 to 12 were measured 3 times by 5 qualified observers. Each digital measurement included (1) BA using the estimated central humeral line; (2) BA using the medial humeral line (BA-MHL); and (3) BA using the lateral humeral line (BA-LHL). Inadequate radiographs or those showing any indication of current or previous fracture were excluded. Intraobserver reliability was estimated for each rater using a 1-way analysis of variance model and interobserver reliability of each set of measurements was estimated using a 2-way analysis of variance. The mean and SD for the BA, BA-MHL, and BA-LHL in females were 70.0 (6.73), 68.0 (6.84), and 72.3 (7.93), respectively, and for males 73.0 (5.22), 70.0 (5.56), and 76.0 (6.18), respectively. ...Continue Reading

References

Nov 1, 1986·The Journal of Bone and Joint Surgery. British Volume·P Worlock
Jul 10, 1999·Journal of Pediatric Orthopedics. Part B·L Dai
Sep 16, 2000·The Journal of Bone and Joint Surgery. British Volume·S Harish
Feb 13, 2001·Injury·J D Acton, M A McNally
May 3, 2008·The Journal of Bone and Joint Surgery. American Volume·Reza OmidDavid L Skaggs

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