Evaluation of the Elbow Carrying Angle in Healthy Individuals

Abstract

SUMMARY:Carrying angle, or cubital angle defined as the acute angle formed by the median axis of the arm when forearm is in fully extended and supinated position. This angle changes with skelatal growth and maturity. This study was aimed to investigate the correlation of carrying angle with bi-acromial diameter and bi-acromial diameter/bi-trochanteric diameter in our healthy young adult population. This was a cross-sectional study that included 400 (204 male,196 female) young adult students selected from Çukurova University aged between 18-25 years (mean±standard deviation of females: 20.11±2.05 years; mean±standard deviation of males: 20.45±1.82 years) which originated from different cities in Turkey. After recording demographic data, carrying angle, forearm length, arm length, bi-trochanteric diameter and bi-acromial diameter were measured by using nonelastic tape measure, pelvimeter and manuel goniometer. In addition, body mass index and bi-acromial diameter/bi-trochanteric diameter were calculated for each participants. The mean values of body height and weight were in following respectively for both genders: 178.53±6.40 cm (male), 163.88±5.73 cm (female); 74.89±10.81 kg (male), 57.56±8.61 kg (female). Whereas on dominant arm this angle was as in males 9.77°±2.82° and 13.94°±3.97°i n females. The mean value of the carrying angle on nondominant arm in males was 9.85°±2.95° and 14.03°±4.08° in females. The mean carrying angle was 9.81°±2.82° in males and 13.99°±3.97° in females. There are linear relationship between the carrying angle and height (r=-0.474, p<0.001, bi-acromial diameter (r=-0.490, p<0.001), bi-acromial diameter/bi-trochanteric diameter (r=-0.449, p<0.001), forearm length (r=-0.366, p<0.001) and arm length (r=-0.273, p<0.001). We believe that the reference values of carrying angle will help the clinician in the management of elbow displacements, fractures, prosthetic design and diagnosis of epicondylar diseases.

Association Between Increased Elbow Carrying Angle and Lateral Epicondylitis

“…The possible etiologic factors for lateral epicondylitis include repetitive microtrauma due to overuse, larger magnitude traumas or manual labor, and anatomical factors, although unclear [7]. In some studies [8,9], ECA abnormalities have been related to diseases such as medial/lateral epicondylitis and ulnar nerve neuropathies; however, some studies have found no relation between ECA and LE [5,6]. The most relevant finding of this study is that increased elbow carrying angles measured radiographically are associated with lateral epicondylitis, although we know the pathogenesis of lateral epicondylitis is multifactorial.…”

Mean Carrying Angle of Elbow in Children Less Than Ten Years of Age

“…Most carrying angle alterations are reported after distal humeral supracondylar fracture. A variety of methods, ranging from basic hand-held goniometers to more involved radiological techniques, have been used to determine carrying angle [8][9][10] . The primary goal of our research was to determine the average carrying angle in a paediatric population, and the secondary goal was to examine how carrying angle related to other characteristics.…”

“…Significant correlation was found between the carrying angle and forearm length 7 . In a different research, the average (SD) carrying angle was 9.81°(±2.82°) for males and 13.99° (±3.97° ) for females 8 .…”

Variation in carrying angle - A normative study

“…The angle formed between the arm's median axis and the completely extended and supinated forearm, known as the carrying angle, describes the forearm's lateral obliquity (Acikgoz et al, 2018). 2 This angle is most accurately measured when the forearm is supinated, the elbow is fully extended, and the shoulder is rotated outward.…”