Cubitus Varus Deformity Following Supracondylar Fracture of the Humerus

Yamamoto, Isao; Ishii, Seiichi; Usui, Masamichi; Ogino, Toshihiko; Kaneda, Kiyoshi

doi:10.1097/00003086-198512000-00028

Cited by 66 publications

(47 citation statements)

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“…[1][2][3][4][5][6][7] It is tridimensional and caused by a medial list and/or rotation, and some extension of the distal fracture fragment. 4,6,10,12,13 Its treatment outcomes are better in children than in adults, because of superior growth correction in youth and hence a better range of motion can be achieved. 2 To avoid the cosmetically unacceptable 'lazy S' deformity of the elbow, various surgical techniques have been introduced.…”

Section: Discussionmentioning

confidence: 99%

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Lateral Closing Wedge Osteotomy with or without Medialisation of the Distal Fragment for Cubitus Varus

Moon

Kim

et al. 2010

J Orthop Surg (Hong Kong)

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Purpose.To compare treatment outcomes after closing wedge osteotomy and plate fixation for cubitus varus deformity undertaken with or without medialisation of the distal fragment. Methods. Records of 21 men and 16 women aged 20 to 34 years who underwent closing wedge osteotomy and plate fixation for cubitus varus deformity with (n=21) or without (n=16) medialisation of the distal fragment were reviewed. A daily alternate flexionextension splinting was applied for one week for early restoration of full range of motion. The carrying angle and range of motion of the elbow were measured. Results. All patients regained the normal carrying angle and range of motion; none had loss of fixation or limitation in range of motion exceeding 10º. Outcomes were excellent in 23 patients and good in 9. A small bony prominence over the lateral condylar region ('lazy S' deformity) was noted in group-1 but not group-2 patients. Conclusion.Closing wedge supracondylar osteotomy with medialisation of the distal fragment was an effective treatment for cubitus varus deformity and minimised the risk of 'lazy S' deformity.

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Section: Discussionmentioning

confidence: 99%

“…2 To avoid the cosmetically unacceptable 'lazy S' deformity of the elbow, various surgical techniques have been introduced. [8][9][10][11][12][13] The pentalateral osteotomy…”

Section: Discussionmentioning

confidence: 99%

Lateral Closing Wedge Osteotomy with or without Medialisation of the Distal Fragment for Cubitus Varus

Moon

Kim

et al. 2010

J Orthop Surg (Hong Kong)

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“…To avoid the effect of rotation on the flexion-extension arc, the medial and lateral condyles were held on a horizontal plane [15]. According to Yamamoto et al [34], with the elbow in 90°flexion and the shoulder in hyperextension, the angle made between the forearm and back was measured as the rotational alignment. If the difference in rotational alignment in both sides was greater than 10°, we noted it as excessive and considered correction of the rotational deformity.…”

Section: Methodsmentioning

confidence: 99%

Surgical Technique: Spike Translation: A New Modification in Step-cut Osteotomy for Cubitus Varus Deformity

Moradi

Vahedi

Ebrahimzadeh

2013

Clinical Orthopaedics &Amp; Related Research

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Background Various methods of osteotomy have been proposed for the treatment of cubitus varus. We designed a modification of the step-cut osteotomy to achieve more correction of the deformity. We describe this new technique called spike translation step-cut osteotomy and report the clinical and radiographic outcomes (deformity correction, ROM, function, osteotomy healing, complications) in a series of patients treated for cubitus varus using this technique. Description of TechniqueThe technique involves a kind of closing-wedge osteotomy with a lateral spike to correct cubitus varus. To avoid lateral epicondyle prominence, the spike is translated medially and embedded in the proximal segment. Methods We treated 13 patients with cubitus varus using the new technique between 2005 and 2010. We compared preoperative and postoperative clinical and radiographic parameters (humerus-elbow-wrist angle, lateral prominence index, arc of elbow motion, DASH score) for all patients. Time to union was recorded. Postoperative evaluation was performed according to the modified criteria of Oppenheim et al. Minimum followup was 16 months (average, 27 months; range, 16-43 months). ResultsThe average humerus-elbow-wrist angle improved from À26°to 11°. The mean lateral prominence index did not differ after correction of deformity compared with the normal side. By using our rehabilitation protocol, all patients regained preoperative arcs of elbow motion in a mean of 2.5 months (range, 1.50-3.50 months) postoperatively, and the mean union time was 1.65 months. According to the criteria of Oppenheim et al., there were 11 excellent and two good results. Conclusions Our spike translation step-cut osteotomy with a larger contact surface of cancellous bone can be a reasonable alternative for correction of a cubitus varus deformity, with satisfactory deformity correction, reliable healing of osteotomy, and low complication rates. Level of Evidence Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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“…The humerus-elbow-wrist angle was measured on the anteroposterior radiographs ( Fig 1A) [10]. We determined the extent of rotational deformity by physical examination in which the angle between the forearm and the back was measured with the elbow in 90°flexion and the shoulder in hyperextension [29]. Range of motion of the elbow was measured while holding the medial and lateral condyle in the same horizontal plane to see the true flexion contracture of the elbow [10].…”

Section: Methodsmentioning

confidence: 99%

Oblique Closing Wedge Osteotomy and Lateral Plating for Cubitus Varus in Adults

Gong

Chung

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Corrective osteotomy around the elbow can require longer recovery time in adults than in children because of the longer healing period and the propensity for stiffness. We hypothesized a lateral oblique closing wedge osteotomy with a larger contact area and fixation with a lag screw plus early motion would provide stable fixation and early motion recovery in adults with cubitus varus deformity. Twelve consecutive patients who needed surgery were treated using this procedure. They were allowed active motion exercises 1 week postoperatively. The age of the patients at the time of surgery averaged 39 years (range, 31-48 years). The minimum followup was 15 months. All patients achieved healing of the osteotomy, and regained preoperative arcs of elbow motion at a mean of 7.3 weeks (range, 2-12 weeks) postoperatively. The average humerus-elbow-wrist angle improved from -23.3°t o 8°(p \ 0.002) by a mean gain of 29.6°. The mean lateral prominence index did not increase postoperatively. The final MEPI and DASH score averaged 95.4 points and 5.5 points. No patient experienced nerve palsy. Oblique osteotomy and fixation with a lag screw and lateral plating is a reasonable alternative technique for cubitus varus in adults, with early recovery of elbow motion and satisfactory deformity correction.

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Cubitus Varus Deformity Following Supracondylar Fracture of the Humerus

Cited by 66 publications

References 0 publications

Lateral Closing Wedge Osteotomy with or without Medialisation of the Distal Fragment for Cubitus Varus

Lateral Closing Wedge Osteotomy with or without Medialisation of the Distal Fragment for Cubitus Varus

Surgical Technique: Spike Translation: A New Modification in Step-cut Osteotomy for Cubitus Varus Deformity

Oblique Closing Wedge Osteotomy and Lateral Plating for Cubitus Varus in Adults

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