Dome osteotomy using the paratricipital (triceps-sparing) approach for cubitus varus deformity in children

Abstract

Twenty patients (11 males and nine females) with cubitus varus deformity were treated with corrective dome osteotomy through the paratricipital approach. Patients presented after an average 3 years of appearance of the deformity. The average age of the patients was 8.5 years (range 6-14 years). All patients had a previous history of supracondylar fracture. Preoperatively, carrying angle, lateral condylar prominent index, and range of motion were recorded. There were no intraoperative complications. Postoperatively, three patients developed a superficial skin infection. No patient had unsightly scarring or a prominent lateral condyle. No patient reported pain, motor weakness, or atrophy of the arm musculature. There was no fixation failure or loss of correction during the healing stage and no revision surgery was needed. The results were graded according to the preoperative and postoperative carrying angle, movement of flexion and extension, and lateral condylar prominence index and they were evaluated statistically. Preoperative and postoperative extension, carrying angle, and lateral condylar prominence index were statistically significant. Corrective dome osteotomy using the paratricipital approach seems to be a reliable technique for correction of cubitus varus in children. The procedure is relatively simple and enables correction of the deformity without inducing lateral condylar prominence.

3D-printed model and osteotomy template technique compared with conventional closing-wedge osteotomy in cubitus varus deformity

“…The most common late complication of SFH is the cubitus varus deformity that results from the malunion of the fractures. Various osteotomy techniques have been described in the literature and can be divided into four parts, including lateral closing wedge osteotomy 6 , 18 , 19 , dome osteotomy 22 , 42 , complex (multiplanar) osteotomy 9 , 17 , 26 , and distraction osteogenesis 38 , 43 . The complications following the corrective osteotomy range from 13 to 34%, and increase with the complexity of the surgical technique 43 .…”

“…Several surgical techniques for corrective osteotomy of cubitus varus deformity of the humerus have been reported. Such osteotomy techniques include medial open wedge osteotomy 17 , lateral closing wedge osteotomy 18 , 19 , reverse V osteotomy 20 , 21 , dome osteotomy 22 , coronal and sagittal plane-based closing wedge osteotomy 23 , 24 , These techniques are technically simple and widely performed, but only correct the varus or varus and extension components of the deformity. Initially, it was thought that the correction of internal rotation is not necessary 25 .…”

Neural wedge osteotomy method of correction for cubitus varus deformity in children

“…The cubitus varus deformity in children, which cannot be reshaped with growth, is mostly caused by the excessive varus of the distal humerus after supracondylar fracture of the humerus. [9] The cubitus varus deformity not only causes serious observable abnormalities (Fig. 7 and 8), but also alters the upper limb weight-bearing alignment, resulting in an increased risk of lateral humeral condyle fracture.…”

Application of computer simulation in the treatment of traumatic cubitus varus deformity in children

“…[2,3] Supracondylar osteotomy is one of the common surgical procedures for the treatment of cubitus varus deformity in children. There are various techniques for performing supracondylar osteotomy, including lateral closing-wedge osteotomy, [4,5] medial opening-wedge osteotomy, [6] dome osteotomy, [7] and reverse V osteotomy. [8,9] However, performing osteotomy with an accurate angle is a challenge.…”