In vivo 3-dimensional Kinematics of Cubitus Valgus after Non-united Lateral Humeral Condyle Fracture
10.5397/cise.2018.21.3.151
- Author:
Eugene KIM
1
;
Se Jin PARK
;
Ho Seok LEE
;
Jai Hyung PARK
;
Jong Kuen PARK
;
Sang Hoon HA
;
Tsuyoshi MURASE
;
Kazuomi SUGAMOTO
Author Information
1. Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. qortn97@naver.com
- Publication Type:Original Article
- Keywords:
Three-dimensional image;
In vivo;
Biomechanical phenomena;
Elbow joint;
Cubitus valgus
- MeSH:
Biomechanical Phenomena;
Congenital Abnormalities;
Elbow;
Elbow Joint;
Imaging, Three-Dimensional;
Joints;
Osteotomy;
Tomography, X-Ray Computed
- From:Clinics in Shoulder and Elbow
2018;21(3):151-157
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. METHODS: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, 90° flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. RESULTS: Ulno-humeral joint moved to the varus on the coronal plane during flexion, 25.45° in the non-united cubitus valgus group and −2.03° in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane −26.75° in the non-united cubitus valgus group and −3.09° in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. CONCLUSIONS: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.
