Supracondylar Humeral Osteotomy for Traumatic Childhood Cubitus Varus Deformity

Oppenheim, William L.; Clader, Timothy J.; Smith, Chadwick F.; Bayer, Michael

doi:10.1097/00003086-198409000-00005

Cited by 129 publications

(157 citation statements)

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“…performed 45 corrective supracondylar osteotomies in 43 children with a 24% complication rate, including neurapraxia, sepsis, and cosmetically unacceptable scarring [31]. With slightly improved results, Labelle et al reported 33% unsatisfactory results after 15 supracondylar osteotomies [13].…”

Section: Introductionmentioning

confidence: 99%

A new surgical technique for the treatment of supracondylar humerus fracture malunions in children

Skaggs

Glassman

Weiss

et al. 2011

Journal of Children's Orthopaedics

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Purpose To report a new locking lateral closing wedge osteotomy used in repairing pediatric supracondylar humerus fracture malunions, which allows for coronal and sagittal plane correction of both cubitus varus and extension. Methods At our institution, eight children with cubitus varus resulting from prior supracondylar humerus fracture malunions underwent a new technique of lateral closing wedge osteotomy performed by a single surgeon. Preoperative templating created from radiographs of the bilateral upper extremities were compared with clinical exam to determine the angle of triangular bone that must be removed in order to correct the varus and any extension deformity. A lateral approach and subperiosteal dissection exposed the distal humerus. A transverse osteotomy created a proximal and distal fragment, from which two triangles of bone were removed. The fragments were reunited, parallel lateral pins were placed, and live imaging confirmed stable fixation. Results The osteotomy was performed in eight patients, with an average age of 6.3 years. The mean interval between the initial injury and corrective osteotomy was 2.4 years. All patients ended up with flexion of 130°or greater with full and symmetrical pronation and supination. The average ulnohumeral angular correction was 25.5°, which was within 2°of the uninvolved elbow in seven patients and to within 5°in one patient. Baumann's angle averaged 85.3°preoperatively and 73.7°postoperatively, with an average 70.2°in the uninvolved elbow. All of the patients healed with excellent clinical and radiographic alignment and complete function. There were no complications or revisions. Conclusion Varus malunion is a well-described complication of pediatric supracondylar humerus fracture repairs, and many different osteotomy techniques have been described. This series demonstrates that an interlocking lateral wedge osteotomy with parallel lateral pin fixation can provide reliable correction of varus and extension deformity, with a minimal complication rate.

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Section: Introductionmentioning

confidence: 99%

A new surgical technique for the treatment of supracondylar humerus fracture malunions in children

Skaggs

Glassman

Weiss

et al. 2011

Journal of Children's Orthopaedics

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“…Table 2. Modified criteria of Oppenheim et al [26] as modified by Kim et al [15] Results No patient had ulnar nerve palsy and wound problems. Two patients complained of the hypertrophic scar.…”

Section: Resultsmentioning

confidence: 98%

“…Based on the criteria of Oppenheim et al [26], there were 11 excellent and two good results. The average union time was 1.7 months (range, 1-2 months).…”

Section: Resultsmentioning

confidence: 99%

“…Functional outcome was evaluated using the Persian version of the DASH score [24]. Finally, postoperative evaluation was performed according to the criteria of Oppenheim et al [26] as modified by Kim et al [15] (Table 2) for comparison with previous studies.…”

Section: Methodsmentioning

confidence: 99%

“…We assessed improvement in (1) elbow alignment (humeruselbow-wrist [HEW] angle and lateral prominence index [LPI]), (2) ROM, (3) function (DASH score); (4) osteotomy healing; and (5) complications. The overall result was judged using the modified criteria of Oppenheim et al [26].…”

Section: Introductionmentioning

confidence: 99%

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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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Mechanistic Insights into CN Coupling Catalyzed by 1,3‐Diketonate‐Ligated Copper: Unprecedented Activation of Aryl Iodide

et al. 2010

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The mechanism of CN cross‐coupling reactions catalyzed by CuI associated to a 1,3‐diketonate ligand L− is investigated by cyclic voltammetry and 1H NMR spectroscopy up to the formation of the key anionic complex [LCuINHCy]−. Its reaction with PhI, shown experimentally, proceeds via an unusual iodide activation, and the transition states are investigated by density functional calculations.

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Supracondylar Humeral Osteotomy for Traumatic Childhood Cubitus Varus Deformity

Cited by 129 publications

References 0 publications

A new surgical technique for the treatment of supracondylar humerus fracture malunions in children

A new surgical technique for the treatment of supracondylar humerus fracture malunions in children

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

Mechanistic Insights into CN Coupling Catalyzed by 1,3‐Diketonate‐Ligated Copper: Unprecedented Activation of Aryl Iodide

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