Skip to main content
Top
Published in: Clinical Orthopaedics and Related Research® 9/2008

01-09-2008 | Original Article

Increased Carrying Angle is a Risk Factor for Nontraumatic Ulnar Neuropathy at the Elbow

Authors: Chein-Wei Chang, MD, Yi-Chian Wang, MD, Chang-Hung Chu, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 9/2008

Login to get access

Abstract

The literature suggests a possible relationship between carrying angle and nontrauma-related ulnar neuropathy. To confirm that relationship, we asked whether carrying angle is a risk factor in patients with nontrauma-related ulnar neuropathy. We measured the carrying angles of the elbow in 36 patients with a clinically and electrophysiologically confirmed diagnosis of nontraumatic ulnar neuropathy at the elbow and in 50 healthy control subjects. Correlation analysis was performed between carrying angles and parameters of nerve conduction studies, including nerve conduction velocities and amplitudes of muscle and nerve action potentials. The mean carrying angle was greater in the patients than in the control subjects. Females had a greater carrying angle than males. We observed an inverse relationship between carrying angles and motor nerve conduction velocities at cross-elbow segments of the ulnar nerves and with sensory nerve conduction velocities of the distal ulnar nerves. An increased carrying angle of the elbow appears to be an independent risk factor of nontrauma-related ulnar neuropathy.
Level of Evidence: Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Literature
1.
go back to reference Abe M, Ishizu T, Shirai H, Okamoto M, Onomura T. Tardy ulnar nerve palsy caused by cubitus varus deformity. J Hand Surg Am. 1995;20:5–9.PubMedCrossRef Abe M, Ishizu T, Shirai H, Okamoto M, Onomura T. Tardy ulnar nerve palsy caused by cubitus varus deformity. J Hand Surg Am. 1995;20:5–9.PubMedCrossRef
2.
go back to reference American Association of Electrodiagnostic Medicine, Campbell WW. Guidelines in electrodiagnostic medicine: practice parameter for electrodiagnostic studies in ulnar neuropathy at the elbow. Muscle Nerve Suppl. 1999;8:S171–205. American Association of Electrodiagnostic Medicine, Campbell WW. Guidelines in electrodiagnostic medicine: practice parameter for electrodiagnostic studies in ulnar neuropathy at the elbow. Muscle Nerve Suppl. 1999;8:S171–205.
3.
go back to reference Atkinson WB, Elftman H. The carrying angle of the human arm as a secondary sex character. Anat Rec. 1945;91:49–52.CrossRef Atkinson WB, Elftman H. The carrying angle of the human arm as a secondary sex character. Anat Rec. 1945;91:49–52.CrossRef
4.
go back to reference Balasubramanian P, Madhuri V, Muliyil J. Carrying angle in children: a normative study. J Pediatr Orthop B. 2006;15:37–40.PubMed Balasubramanian P, Madhuri V, Muliyil J. Carrying angle in children: a normative study. J Pediatr Orthop B. 2006;15:37–40.PubMed
5.
go back to reference Beals RK. The normal carrying angle of the elbow: a radiographic study of 422 patients. Clin Orthop Relat Res. 1976;119:194–196.PubMed Beals RK. The normal carrying angle of the elbow: a radiographic study of 422 patients. Clin Orthop Relat Res. 1976;119:194–196.PubMed
6.
go back to reference Beekman R, Van Der Plas JP, Uitdehaag BM, Schellens RL, Visser LH. Clinical, electrodiagnosis, and sonographic studies in ulnar neuropathy at the elbow. Muscle Nerve. 2004;30:202–208.PubMedCrossRef Beekman R, Van Der Plas JP, Uitdehaag BM, Schellens RL, Visser LH. Clinical, electrodiagnosis, and sonographic studies in ulnar neuropathy at the elbow. Muscle Nerve. 2004;30:202–208.PubMedCrossRef
7.
go back to reference Cain EL Jr, Dugas JR, Wolf RS, Andrews JR. Elbow injuries in throwing athletes: a current concepts review. Am J Sports Med. 2003;31:621–635.PubMed Cain EL Jr, Dugas JR, Wolf RS, Andrews JR. Elbow injuries in throwing athletes: a current concepts review. Am J Sports Med. 2003;31:621–635.PubMed
8.
go back to reference Chiodo A, Chadd E. Ulnar neuropathy at or distal to the wrist: traumatic versus cumulative stress cases. Arch Phys Med Rehabil. 2007;88:504–512.PubMedCrossRef Chiodo A, Chadd E. Ulnar neuropathy at or distal to the wrist: traumatic versus cumulative stress cases. Arch Phys Med Rehabil. 2007;88:504–512.PubMedCrossRef
9.
go back to reference Golden DW, Jhee JT, Gilpin SP, Sawyer JR. Elbow range of motion and clinical carrying angle in a healthy pediatric population. J Pediatr Orthop B. 2007;16:144–149.PubMed Golden DW, Jhee JT, Gilpin SP, Sawyer JR. Elbow range of motion and clinical carrying angle in a healthy pediatric population. J Pediatr Orthop B. 2007;16:144–149.PubMed
10.
go back to reference Habernek H, Ortner F. The influence of anatomic factors in elbow joint dislocation. Clin Orthop Relat Res. 1992;274:226–230.PubMed Habernek H, Ortner F. The influence of anatomic factors in elbow joint dislocation. Clin Orthop Relat Res. 1992;274:226–230.PubMed
11.
go back to reference Hui JH, Torode IP, Chatterjee A. Medial approach for corrective osteotomy of cubitus varus: a cosmetic incision. J Pediatr Orthop. 2004;24:477–481.PubMed Hui JH, Torode IP, Chatterjee A. Medial approach for corrective osteotomy of cubitus varus: a cosmetic incision. J Pediatr Orthop. 2004;24:477–481.PubMed
12.
go back to reference Hutchinson MR, Wynn S. Biomechanics and development of the elbow in the young throwing athlete. Clin Sports Med. 2004;23:531–544, viii.PubMedCrossRef Hutchinson MR, Wynn S. Biomechanics and development of the elbow in the young throwing athlete. Clin Sports Med. 2004;23:531–544, viii.PubMedCrossRef
13.
go back to reference Kanazawa S, Fujioka H, Kanatani T, Tsunoda M, Saura R, Mizuno K. The relation between cubital tunnel syndrome and the elbow alignment. Kobe J Med Sci. 1994;40:155–163.PubMed Kanazawa S, Fujioka H, Kanatani T, Tsunoda M, Saura R, Mizuno K. The relation between cubital tunnel syndrome and the elbow alignment. Kobe J Med Sci. 1994;40:155–163.PubMed
14.
go back to reference Khare GN, Goel SC, Saraf SK, Singh G, Mohanty C. New observations on carrying angle. Indian J Med Sci. 1999;53:61–67.PubMed Khare GN, Goel SC, Saraf SK, Singh G, Mohanty C. New observations on carrying angle. Indian J Med Sci. 1999;53:61–67.PubMed
15.
go back to reference Lo YL, Leoh TH, Xu LQ, Nurjannah S, Dan YF. Short-segment nerve conduction studies in the localization of ulnar neuropathy of the elbow: use of flexor carpi ulnaris recordings. Muscle Nerve. 2005;31:633–636.PubMedCrossRef Lo YL, Leoh TH, Xu LQ, Nurjannah S, Dan YF. Short-segment nerve conduction studies in the localization of ulnar neuropathy of the elbow: use of flexor carpi ulnaris recordings. Muscle Nerve. 2005;31:633–636.PubMedCrossRef
16.
go back to reference Nishimura A, Ogura T, Hase H, Makinodan A, Hojo T, Katsumi Y, Yagi K, Mikami Y, Kubo T. A correlative electrophysiologic study of nerve fiber involvement in carpal tunnel syndrome using current perception thresholds. Clin Neurophysiol. 2004;115:1921–1924.PubMedCrossRef Nishimura A, Ogura T, Hase H, Makinodan A, Hojo T, Katsumi Y, Yagi K, Mikami Y, Kubo T. A correlative electrophysiologic study of nerve fiber involvement in carpal tunnel syndrome using current perception thresholds. Clin Neurophysiol. 2004;115:1921–1924.PubMedCrossRef
17.
go back to reference Norkin C, Levangie P. The elbow complex. In: Norkin C, ed. Joint Structure and Function: A Comprehensive Analysis. 3rd ed. Philadelphia, PA: FA Davis; 2001:226–250. Norkin C, Levangie P. The elbow complex. In: Norkin C, ed. Joint Structure and Function: A Comprehensive Analysis. 3rd ed. Philadelphia, PA: FA Davis; 2001:226–250.
18.
go back to reference Ogino T, Minami A, Fukuda K. Tardy ulnar nerve palsy caused by cubitus varus deformity. J Hand Surg Br. 1986;11:352–356.PubMedCrossRef Ogino T, Minami A, Fukuda K. Tardy ulnar nerve palsy caused by cubitus varus deformity. J Hand Surg Br. 1986;11:352–356.PubMedCrossRef
19.
go back to reference Oh SJ. Clinical Electromyography Nerve Conduction Studies, 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003:44. Oh SJ. Clinical Electromyography Nerve Conduction Studies, 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003:44.
20.
go back to reference Paraskevas G, Papadopoulos A, Papaziogas B, Spanidou S, Argiriadou H, Gigis J. Study of the carrying angle of the human elbow joint in full extension: a morphometric analysis. Surg Radiol Anat. 2004;26:19–23.PubMedCrossRef Paraskevas G, Papadopoulos A, Papaziogas B, Spanidou S, Argiriadou H, Gigis J. Study of the carrying angle of the human elbow joint in full extension: a morphometric analysis. Surg Radiol Anat. 2004;26:19–23.PubMedCrossRef
21.
go back to reference Snell RS. Clinical Anatomy, 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2004:551. Snell RS. Clinical Anatomy, 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2004:551.
22.
go back to reference Van Roy P, Baeyens JP, Fauvart D, Lanssiers R, Clarijs JP. Arthro-kinematics of the elbow: study of the carrying angle. Ergonomics. 2005;48:1645–1656.PubMedCrossRef Van Roy P, Baeyens JP, Fauvart D, Lanssiers R, Clarijs JP. Arthro-kinematics of the elbow: study of the carrying angle. Ergonomics. 2005;48:1645–1656.PubMedCrossRef
23.
go back to reference Yilmaz E, Karakurt L, Belhan O, Bulut M, Serin E, Avci M. Variation of carrying angle with age, sex, and special reference to side. Orthopedics. 2005;28:1360–1363.PubMed Yilmaz E, Karakurt L, Belhan O, Bulut M, Serin E, Avci M. Variation of carrying angle with age, sex, and special reference to side. Orthopedics. 2005;28:1360–1363.PubMed
Metadata
Title
Increased Carrying Angle is a Risk Factor for Nontraumatic Ulnar Neuropathy at the Elbow
Authors
Chein-Wei Chang, MD
Yi-Chian Wang, MD
Chang-Hung Chu, MD
Publication date
01-09-2008
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 9/2008
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-008-0308-2

Other articles of this Issue 9/2008

Clinical Orthopaedics and Related Research® 9/2008 Go to the issue