A Comparative Study of the Modified Baumann's Angle Between the Dominant and Non-Dominant Sides in a North Indian Pediatric Population

Cureus. 2023 Oct 25;15(10):e47687. doi: 10.7759/cureus.47687. eCollection 2023 Oct.

Abstract

Background The literature points towards the fact that paediatric elbow fractures happen more frequently and have greater variability when contrasted with adults. Between 65%-75% of pediatric fractures involve the upper extremity, and supracondylar humerus is the most common of them all. To know the exact site of injury and to estimate the degree of reduction after manipulation, the modified Baumann's angle, the Baumann's angle, the Humero-condylar angle, the Anterior humeral line, and the Radio-capitellar line are the parameters most commonly used. This study was carried out to compare the modified Baumann's angle between both upper limbs in the paediatric population. Methodology This cross-sectional study was conducted in a tertiary health care centre in Northern India for one year from September 1, 2021, to August 31, 2022. We included pediatric patients in the age group of 3-16 years. Age, sex, weight, height, BMI, secondary sexual characters, and handedness were noted in all the children enrolled in our study. In both the dominant and non-dominant sides, the mean arm length, the forearm length, the inter-epicondylar distance, the clinical carrying angle, the radiological carrying angle, and the modified Baumann's angle were calculated. Results A total of 113 children were enrolled in the study. The majority of children (71.7%) had dominance on the right side. In both the dominant side and non-dominant side, mean arm length, forearm length, inter-epicondylar distance, clinical carrying angle, radiological carrying angle, and modified Baumann's angle values were calculated. On evaluating the data statistically, a significant difference between the two sides was observed for all the parameters (p<0.05), except forearm length (p-value -0.954). Multivariate analysis showed that only BMI was significantly negatively associated with modified Baumann's angle (p=0.016), and only age (0.019) and BMI (<0.001) were found to be significantly associated with the difference in modified Baumann's angle. Conclusions The findings of this study will be helpful in the management of elbow disorders and their reconstruction following trauma. A significant difference was found in the modified Baumann's angle between dominant and non-dominant sides, and it also showed a negative significant correlation with arm length, forearm length, and the presence of secondary sexual characteristics. The equations derived in this study will be helpful in the simple derivation of the modified Baumann's angle and its difference from simple measurements of the upper limb parameters.

Keywords: arm length; elbow carrying angle; forearm length; inter-epicondylar distance; modified baumann’s angle; pediatric anatomy; pediatric orthopedics; radiological carrying angle.