Baumann’s Angle

Baumann’s Angle
• Baumann's angle is used for assessing supracondylar fractures
(distal fracture of the humerus).
• Gartland’s Classification
 How to:
• The angle is determined by:

• drawing a line straight down through the

middle/long axis of the humeral
shaft

• then through the trochlea

• then drawing a line that is perpendicular

to the humeral shaft line

• then a line is made parallel, but running

through the lateral condylar physis
Normal Value
• The angle between the
humeral shaft line and the
parallel line to the lateral
condylar physis should be
about 70 - 75 degrees
Clinical Application
• The angle between the humeral shaft line and the parallel line to the
lateral condylar physis should be about 70-75 degrees.
• Anything greater than this is concerning for fracture with displacement.
• It should be compared to the contralateral (non-injured elbow)
• a difference of more than 5 degrees suggests a coronal plane deformity.
Nonoperative tx
• Acceptable alignment
• Younger children
• < 35-45 deg angulation
• Older children
• < 20 deg varus/valgus
• < 20 deg procurvatum
• <15 deg rotation malalignment
• < 2cm shortening
• => Non-op Immobilization due to good remodeling potential

• Techniques
• Sling and swathe or cuff and collar in young children
• Coaptation splint or hanging arm cast
• Sarmiento functional brace in older children/adolescents
• ROM exercises can be initiated in 2-3 weeks once pain is controlled
Operative tx
• Open reduction internal fixation
• Indications
• Open fractures
• Multiply injured patient
• Ipsilateral forearm fractures
• “Floating elbow"
• Associated shoulder injury
• Unacceptable alignment
• Techniques
• Flexible intramedullary nail fixation
• Anterior, anterolateral or posterior approach with 3.5mm or 4.5mm plate fixation
References
• 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 Sep-Oct;12(5):636-9. PMID: 1517426.
• Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF. Fracture and
Dislocation Classification Compendium-2018. (2018) Journal of orthopaedic
trauma. 32 Suppl 1: S1-S170. doi:10.1097/BOT.0000000000001063 - Pubmed
• Mulpuri, K., Hosalkar, H., & Howard, A. (2012). AAOS Clinical Practice
Guideline: The Treatment of Pediatric Supracondylar Humerus Fractures.
Journal of the American Academy of Orthopaedic Surgeons, 20(5), 328–330.
doi:10.5435/JAAOS-20-05-328 (https://doi.org/10.5435/JAAOS-20-05-328)