Background: Untreated cubitus varus results in cosmetic deformity as well as posterolateral rotatory instability at the elbow if longstanding. French osteotomy with its modifications is the most commonly done osteotomy and relies on a medial intact hinge and these osteotomies fail to address the lateral prominence. Intraoperative fixator assistance to adjust the translation and fine tune the osteotomy is a novel method to address the lateral prominence. This prospective study analyses the efficacy of the same.
Materials And Methods: A total of 16 consecutive patients presenting with unilateral cubitus varus resulting from mal-united supracondylar fracture of humerus were included. The humero-ulnar angle correction required, size of lateral closing wedge and amount of translation required were calculated. After a lateral surgical approach, one Schanz pin of size 2.5mm-3.5mm depending on age, was passed just above the level of distal humerus physis, lateral to medial; a second pin was inserted in the shaft of humerus, again lateral to medial. Pre-calculated wedge of bone was removed, angular correction as well as translation done; fine tuning of the osteotomy was achieved using fixator assistance. Rotational and hyperextension deformities were corrected simultaneously. Fixation of the osteotomy was done by multiple wires or plates, depending on the age of the patient.
Observation And Results: The mean carrying angle corrected to 10.4 degrees valgus from a preoperative value of 19.8 degrees varus. The mean humero-ulnar angle corrected to 9.6 degrees valgus from a preoperative value of 19.6 degrees varus. The mean lateral prominence index reduced to - 3.8% from a preoperative value of - 5.5%. The mean cosmetic correction score was 9 (Max 10) from a preoperative value of 1.9. No patient had an 'S' shaped deformity in the operated elbow. No nerve palsies were observed in any of the operated patients.
Conclusions: Fixator assistance during surgery allows angular, translation and rotational control of the fragments to fully correct the deformity. It also allows fine tuning of the osteotomy during surgery.
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http://dx.doi.org/10.1007/s43465-024-01312-2 | DOI Listing |
Indian J Orthop
February 2025
Government Medical College and Hospital, Chandigarh, India.
Background: Untreated cubitus varus results in cosmetic deformity as well as posterolateral rotatory instability at the elbow if longstanding. French osteotomy with its modifications is the most commonly done osteotomy and relies on a medial intact hinge and these osteotomies fail to address the lateral prominence. Intraoperative fixator assistance to adjust the translation and fine tune the osteotomy is a novel method to address the lateral prominence.
View Article and Find Full Text PDFJ Hand Microsurg
March 2025
Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam.
Purpose: This study aims to evaluate the effectiveness and safety of lateral closing wedge osteotomy with tension-band wire fixation for correcting cubitus varus deformity in pediatric patients. The primary objective was to assess the bone union rate, functional outcomes, and potential complications associated with this surgical approach.
Methods: We conducted a retrospective review of 104 pediatric cases (ages 7-15) with post-traumatic cubitus varus deformity treated between January 2018 and December 2019 at the Pediatric Orthopedic Department.
J Shoulder Elbow Surg
January 2025
Peachtree Orthopaedic Clinic, Atlanta, GA, USA.
Background: The treatment of patients who suffer a proximal humeral fracture (PHF) remains controversial. The purpose of this study was to find consensus among experts using a validated iterative process in the treatment of patients after a PHF.
Methods: The Neer Circle is an organization of shoulder experts recognized for their service to the American Shoulder and Elbow Surgeons.
Zhongguo Gu Shang
January 2025
Emergency Department, Sichuan Orthopaedic Hospital, Chengdu 610041, Sichuan, China.
Objective: To investigate the clinical efficacy of percutaneous prying combined with modified rotary reduction with needle in the treatment of supracondylar fracture of humerus in Gartland type Ⅳ children, and to evaluate the postoperative elbow joint function, the incidence of elbow varus deformity and the application prospect of this technique.
Methods: A total of 98 children diagnosed with Gartland type Ⅳ supracondylar humeral fractures between June 2020 and January 2023 were included in this study, comprising of 57 males and 41 females. The age ranged from 2 to 14 years old with an average of (6.
Cureus
December 2024
Orthopaedics and Traumatology, Universiti Putra Malaysia, Serdang, MYS.
Distal humerus physeal separation is an uncommon and often misdiagnosed injury in infants and young children, frequently resulting in delayed treatment. We report three cases of distal humerus physeal separation that presented with different clinical scenarios with different management approaches. The first case describes a nine-month-old girl who was initially treated for presumed elbow cellulitis before presentation to our centre six weeks later.
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