Image Fusion of X-ray and Magnetic Resonance Imaging-Based Evaluation of the Stability of Pediatric Lateral Humeral Condyle Fracture




Fracture of Lateral Condyle of Humerus
Degree of displacement


How to Cite

Fang, Z. ., Li, Z. ., Ma, G. ., Jiang, X. ., Zhu, Y. ., & Yin, Z. . (2021). Image Fusion of X-ray and Magnetic Resonance Imaging-Based Evaluation of the Stability of Pediatric Lateral Humeral Condyle Fracture. Iranian Red Crescent Medical Journal, 23(8). (Original work published August 22, 2021)


Background: Lateral humeral condyle fracture is the second most common intra-articular fracture in pediatric elbow.

Objectives: The present study aimed to analyze the differences between X-ray and magnetic resonance imaging (MRI) in the evaluation of the stability of pediatric lateral humeral condyle fracture and the degree of fracture displacement.

Methods: A total of 78 patients with acute elbow trauma were selected and hospitalized in our orthopedic department from July 2018-July 2019. All patients were examined with X-ray and MRI. The sensitivity and specificity of X-ray and MRI in the diagnosis of lateral humeral condyle fracture and the integrity of the trochlear cartilage chain fracture were calculated. The X-ray and MRI were examined respectively to check the value of lateral and posterior fracture space of lateral humeral condyle fracture.

Results: Callus repair was observed according to the observation of fracture line during operation or the follow-up imaging examination of conservative treatment. It was confirmed that out of 78 patients with elbow joint trauma, 72 cases were diagnosed with the fracture of lateral condyle of humerus, and the other 6 patients were cured without fracture signs. The sensitivity of MRI in the diagnosis of pediatric lateral condylar fracture was 100%, which was significantly higher than that of X-ray (88.89%) (P<0.05). The results of X-ray and MRI in the diagnosis of pediatric lateral condylar fracture were generally consistent (kappa value = 0.465;< 0.01). Among the 72 confirmed cases, 35 subjects had a fracture of trochlear cartilage chain. The sensitivity of MRI in the diagnosis of pediatric fracture of lateral condyle of humerus was 97.14%, which was significantly higher than that of X-ray (62.86%) (P<0.05). The difference was statistically significant (P<0.05). The sensitivity of 3d-fs-fspgr or 3d-fspgr was significantly higher than that of fs-t2wi and fs-pdwi (P< 0.05).

Conclusion: As evidenced by the obtained results, MRI was superior to X-ray in the diagnosis of pediatric humeral epicondylar fracture stability and evaluation of fracture displacement. Furthermore, 3d-fs-fspgr or 3d-fspgr was the best MR sequence to show the pediatric humeral epicondylar fracture. These findings can provide theoretical basis for the establishment of clinical treatment plan.


  1. El-Sobky TA, Haleem JF, Sakr HM, Aly AS. A neglected markedly displaced medial epicondyle fracture with simultaneous ulnar nerve palsy in an adolescent. Clin Orthop Surg. 2017;9(4):542-6. doi: 10.4055/cios.2017.9.4.542. [PubMed: 29201310].
  2. Wang KC, Frank RM, Cotter EJ, Christian DR, Cole BJ. Arthroscopic management of isolated tibial plateau defect with microfracture and micronized allogeneic cartilage-platelet-rich plasma adjunct. Arthrosc Tech. 2017;6(5):e1613-e8. doi: 10.1016/j.eats.2017.06.018. [PubMed: 29399444].
  3. Veyssiere A, Leprovost N, Ambroise B, Prévost R, Chatellier A, Bénateau H. Study of the mechanical reliability of an S-shaped adjustable osteosynthesis plate for bilateral sagittal split osteotomies. Study on 15 consecutive cases. J Stomatol Oral Maxillofac Surg. 2018;119(1):19-24. doi: 10.1016/j.jormas.2017.11.003. [PubMed: 29133198].
  4. Villanova J, Laurencin J, Cloetens P, Bleuet P, Delette G, Suhonen H, et al. Corrigendum to'3D phase mapping of solid oxide fuel cell YSZ/Ni cermet at the nanoscale by holographic X-ray nanotomography. J Power Sour. 2018;382:199. doi: 10.1016/j.jpowsour.2018.02.043.
  5. Lu K, He C, Guo N, Chan C, Ni K, Lan G, et al. Low-dose X-ray radiotherapy-radiodynamic therapy via nanoscale metal-organic frameworks enhances checkpoint blockade immunotherapy. Nat Biomed Eng. 2018;2(8):600-10. doi: 10.1038/s41551-018-0203-4. [PubMed: 31015630].
  6. Vennari CE, O’Bannon EF, Williams Q. The ammonium ion in a silicate under compression: infrared spectroscopy and powder X-ray diffraction of NH 4 AlSi 3 O 8-buddingtonite to 30 GPa. Physics Chem Miner. 2017;44(2):149-61. doi: 10.1007/s00269-016-0844-3.
  7. Fernandez FF, Vatlach S, Wirth T, Eberhardt O. Medial humeral condyle fracture in childhood: a rare but often overlooked injury. Eur J Trauma Emerg Surg. 2019;45(4):757-61. doi: 10.1007/s00068-018-0930-y. [PubMed: 29484463].
  8. Hagiwara A, Warntjes M, Hori M, Andica C, Nakazawa M, Kumamaru KK, et al. SyMRI of the brain: rapid quantification of relaxation rates and proton density, with synthetic MRI, automatic brain segmentation, and myelin measurement. Invest Radiol. 2017;52(10):647-57. doi: 10.1097/RLI.0000000000000365. [PubMed: 28257339].
  9. Zamboglou C, Drendel V, Jilg CA, Rischke HC, Beck TI, Schultze-Seemann W, et al. Comparison of 68Ga-HBED-CC PSMA-PET/CT and multiparametric MRI for gross tumour volume detection in patients with primary prostate cancer based on slice by slice comparison with histopathology. Theranostics. 2017;7(1):228-37. doi: 10.7150/thno.16638. [PubMed: 28042330].
  10. Abed Y, Nour K, Kandil YR, El-Negery A. Triple management of cubitus valgus deformity complicating neglected nonunion of fractures of lateral humeral condyle in children: a case series. Int Orthop. 2018;42(2):375-84. doi: 10.1007/s00264-017-3709-6. [PubMed: 29214396].
  11. Lyu JM, Lin CF, Lan LQ. Risk factors of cubitus varus in humeral condylar fracture after conservative treatment in child. Zhongguo Gu Shang. 2017;30(5):431-5. Chinese. doi: 10.3969/j.issn.1003-0034.2017.05.008. [PubMed: 29417774].
  12. Müller M, de Sena Oliveira I, Allner S, Ferstl S, Bidola P, Mechlem K, et al. Myoanatomy of the velvet worm leg revealed by laboratory-based nanofocus X-ray source tomography. Proc Natl Acad Sci U S A. 2017;114(47):12378-83. doi: 10.1073/pnas.1710742114. [PubMed: 29109262].
  13. Abdullah MZ, Saat AB, Hamzah ZB. Assessment of the impact of petroleum and petrochemical industries to the surrounding areas in Malaysia using mosses as bioindicator supported by multivariate analysis. Environ Monit Assess. 2012;184(6):3959-69. doi: 10.1007/s10661-011-2236-y. [PubMed: 21822578].
  14. Usuda K, Sagawa M, Maeda S, Motono N, Tanaka M, Machida Y, et al. Diagnostic performance of whole-body diffusion-weighted imaging compared to PET-CT plus brain MRI in staging clinically resectable lung cancer. Asian Pac J Cancer Prev. 2016;17(6):2775-80. [PubMed: 27356689].
  15. Rajeev A, Tuinebreijer W, Mohamed A, Newby M. The validity and accuracy of MRI arthrogram in the assessment of painful articular disorders of the hip. Eur J Orthop Surg Traumatol. 2018;28(1):71-7. doi: 10.1007/s00590-017-2022-9. [PubMed: 28762158].