Logo of The Journal of Bone & Joint Surgery (Br)
Quick search:        
          Advanced Search
Guest Access | Sign In
Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 8, 1049-1053.
doi: 10.1302/0301-620X.91B8.22567  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Further opinion
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow My Folders
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Braunstein, V.
Right arrow Articles by Biberthaler, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Braunstein, V.
Right arrow Articles by Biberthaler, P.

Use of the fulcrum axis improves the accuracy of true anteroposterior radiographs of the shoulder

V. Braunstein, MD, Orthopaedic Surgeon1; C. Kirchhoff, MD, Orthopaedic Surgeon2; B. Ockert, MD, Orthopaedic Surgeon1; C. M. Sprecher, Senior Engineer, HTL3; M. Korner, MD, Radiologist4; W. Mutschler, MD, Professor1; E. Wiedemann, MD, Professor5; and P. Biberthaler, MD, Professor1

1 Department of Traumatology and Orthopaedic Surgery
2 Department of Orthopaedic Sports Surgery Klinikum Rechts der Isar, Technische Universitaet, Ismaningerstrasse 22, 81675 Munich, Germany.
3 AO Research Institute AO Foundation, Clavadelerstrasse 8, 7270 Davos, Switzerland.
4 Department of Clinical Radiology Ludwig-Maximilians-University, Nussbaumstrasse 20, 80336 Munich, Germany.
5 OCM-Clinic, Steinerstrasse 6, 81369 Munich, Germany.

Correspondence should be sent to Dr V. Braunstein; e-mail: volker.braunstein{at}aofoundation.org

In 100 patients the fulcrum axis which is the line connecting the anterior tip of the coracoid and the posterolateral angle of the acromion, was used to position true anteroposterior radiographs of the shoulder. This method was then compared with the conventional radiological technique in a further 100 patients.

Three orthopaedic surgeons counted the number of images without overlap between the humeral head and glenoid and calculated the amount of the glenoid surface visible in each radiograph. The analysis was repeated for intraobserver reliability. The learning curves of both techniques were studied.

The amount of free visible glenoid space was significantly higher using the fulcrum-axis method (64 vs 31) and the comparable glenoid size increased significantly (8.56 vs 6.47). Thus the accuracy of the anteroposterior radiographs of the shoulder is impaired by using this technique. The intra and interobserver reliability showed a high consistency. No learning curve was observed for either technique.






(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General