CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(06): 1039-1044
DOI: 10.1055/s-0042-1743271
Artigo Original
Ortopedia Pediátrica

The Baumann Angle: An Analysis from Theory to Practice

Article in several languages: português | English
1   Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
,
1   Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
,
1   Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
,
1   Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
,
1   Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
2   Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
,
1   Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
› Author Affiliations

Abstract

Objective To analyze how the Baumann angle (BA) is affected by inadequate radiographic inclinations.

Methods The study was performed from radiographs of the distal humerus of children aged 3 to 10 years. The BA measurements performed by five observers were compared, and each radiograph was evaluated for its quality as “adequate” or “inadequate.” The correlation between radiographic quality and the normality of the angles was evaluated.

Results Sample was composed of 141 patients, 44% between 3 and 6 years of age and 56% between 7 and 10. We observed the BA between 52.01 and 89.82 degrees, with about 16% of the measurements outside the normal limits of the literature. A total of 33.3% of the evaluated radiographs were classified as “inadequate”. On the BA measurements outside the normality parameter, we observed that its proportion was higher among images with inadequate radiographic quality (31.1 vs. 6.2%), and this difference was significant (p < 0.001).

Conclusions The BA is a very variable measurement and, alone, it is unreliable for the evaluation of angular deformities of the pediatric elbow, with radiographic quality proven to be an important causal factor of this variability.

Financial Support

There was no financial support from public, commercial, or non-profit sources.


Work developed at Hospital Albert Einstein, São Paulo, SP, Brazil.




Publication History

Received: 27 August 2021

Accepted: 03 January 2022

Article published online:
25 April 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • Referências

  • 1 Flynn JM, Skaggs DL, Waters PM. Rockwood & Wilkins' fractures in children. 8th ed. Philadelphia: Wolters Kluwer Health; 2015
  • 2 Moraleda L, Valencia M, Barco R, González-Moran G. Natural history of unreduced Gartland type-II supracondylar fractures of the humerus in children: a two to thirteen-year follow-up study. J Bone Joint Surg Am 2013; 95 (01) 28-34
  • 3 Acton JD, McNally MA. Baumann's confusing legacy. Injury 2001; 32 (01) 41-43
  • 4 Vaquero-Picado A, González-Morán G, Moraleda L. Management of supracondylar fractures of the humerus in children. EFORT Open Rev 2018; 3 (10) 526-540
  • 5 Köberle G. Prevention of cubitus varus and cubitus valgus from humerus supracondylar fractures. Rev Bras Ortop 2003; 38 (10) 568-580
  • 6 Patriota GSQA, Assunção Filho CA, Assunção CA. What is the best fixation technique for the treatment of supracondylar humerus fractures in children?. Rev Bras Ortop 2017; 52 (04) 428-434
  • 7 Carvalho RA, Franco Filho N, Castello Neto AB, Reis GD, Dias MP. Fratura supracondiliana de úmero em crianças: fixação com dois fios de Kirschner cruzados. Rev Bras Ortop 2012; 47 (06) 705-709
  • 8 Mohammad S, Rymaszewski LA, Runciman J. The Baumann angle in supracondylar fractures of the distal humerus in children. J Pediatr Orthop 1999; 19 (01) 65-69
  • 9 Williamson DM, Coates CJ, Miller RK, Cole WG. Normal characteristics of the Baumann (humerocapitellar) angle: an aid in assessment of supracondylar fractures. J Pediatr Orthop 1992; 12 (05) 636-639
  • 10 Krengel 3rd WF, Wiater BP, Pace JL. et al. 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. J Pediatr Orthop 2012; 32 (04) 373-377
  • 11 Pace JL, Wiater B, Schmale G, Jinguji T, Bompadre V, Krengel 3rd. W. Baumann angle and radial-ulnar overlap: a radiographic study to control for the angle of the x-ray beam. J Pediatr Orthop 2012; 32 (05) 467-472
  • 12 Shank CF, Wiater BP, Pace JL. et al. The lateral capitellohumeral angle in normal children: mean, variation, and reliability in comparison to Baumann's angle. J Pediatr Orthop 2011; 31 (03) 266-271
  • 13 Altman DG. Practical statistics for medical research. London: CRC press; 1991
  • 14 Silva M, Pandarinath R, Farng E. et al. Inter- and intra-observer reliability of the Baumann angle of the humerus in children with supracondylar humeral fractures. Int Orthop 2010; 34 (04) 553-557
  • 15 Camp J, Ishizue K, Gomez M, Gelberman R, Akeson W. Alteration of Baumann's angle by humeral position: implications for treatment of supracondylar humerus fractures. J Pediatr Orthop 1993; 13 (04) 521-525
  • 16 Segal D, Emery K, Zeitlinger L, Rosenbaum JA, Little KJ. Humerus Rotation Has a Negligible Effect on Baumann Angle in a Wide Range of Rotational Positions. J Pediatr Orthop 2020; 40 (09) e822-e826