MDCT examinations of 155 patients (males: 61 females: 94,
aged 26-68 years) with history of elbow trauma from a time period of nearly 4 years were retrospectively evaluated.
A 6 channel,
multislice scanner (Philips,
Brilliance 6) was used with 0,75mm collimation,
at 3mm thickness,
200mAs and 120 kVp at the time of injury and clinical assessment and sagittal and coronal reformatted images of the shoulder were generated from the axial and sagittal images respectively using the epicondyles as an anatomical reference.
Further humerus fracture classification using images reformatted parallel and perpendicular to the elbow joint space.
The MDCT scans were evaluated in consensus,
by two experienced musculoskeletal radiologists,
two orthopaedic surgeons and one radiology and orthopaedic resident.
All the fractures were analyzed according to AO/OTA trauma classification system and categorized in extra-articular,
partial-articular and complete-articular types that labell A,
B and C respectivelly. Each type is further subdivided into 3 groups (A1,
A2,
A3/B1,
B2,
B3/C1,
C2,
C3) according to ascending order of severity,
to morphological complexities and to difficulties in their treatment and prognosis.
Each group is further subdivided into 3 subgroups,
denoted by a number 1,
2,
3 (a total of 27 subgroups) as follows:
A)Humerus:13-A extra-articular fracture (A1 apophyseal avulsion,
A2 metaphyseal simple,
A3 metaphyseal multifragmentary),
13-B partial articular fracture (B1 sagittal lateral condyle,
B2 sagittal medial condyle,
B3 coronal),
13-C complete articular fracture (C1 articular simple,
metaphyseal simple,
C2 articular simple,
metaphyseal multifragmentary,
C3 articular multifragmentary).
B) Ulna and Radius: 21-A extra-articular fracture (A1 ulna fractured,
radius intact,
A2 radius fractured,
ulna intact,
A3 both bones),
21-B articular fracture (B1 ulna fractured,
radius intact,
B2 radius fractured,
ulna intact,
B3 one bone articular fracture,
other extra-articular),
21-C articular fracture of both bones (C1 simple,
C2 one articular simple,
other articular multifragmentary,
C3 multifragmentary).