Surgical Correction of Cubitus Varus

Bauer, Andrea S.; Pham, Brian; Lattanza, Lisa

doi:10.1016/j.jhsa.2015.12.019

Cited by 35 publications

(42 citation statements)

References 16 publications

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“…Cubitus varus deformity is a common sequela of elbow fractures in children [1][2][3][4]. Although the cause of cubitus varus deformity remains inconclusive, it is considered a three-dimensional (3D) deformity including varus deformity of the coronal plane, an overextension deformity of the sagittal plane, and an internal rotation deformity of the horizontal plane [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

Hu¹,

Zhong²,

Lou

et al. 2020

J Orthop Surg Res

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Background: Cubitus varus deformity is a common sequela of elbow fractures in children. Cubitus varus deformity treatment is tending toward 3D correction, which is challenging for orthopedic surgeons. This study aims to explore whether individualized 3D-printed navigation templates can assist with accurate and effective corrective treatment of children with cubitus varus deformity. Methods: Thirty-five patients were treated for cubitus varus deformity from June 2015 to April 2017, including 21 boys and 14 girls, aged 4.6-13.2 years (average, 7.5 years). Of these cases, 17 deformities were on the left side and 18 were on the right side. All were treated with wedge osteotomy of the lateral distal humerus. 3D-printed navigation templates were used in 16 cases, while traditional surgery was used in 19 cases. All patients underwent computed tomography scans before surgery. Computer software was used to analyze the measurements and design and print individualized navigation templates. The navigation templates were matched, and surgery was initially simulated. Intraoperative individualized navigation templates were used to assist with accurate osteotomy and Kirschner wire fixation. Operation times were recorded in all cases, the carrying angles before and after surgery were assessed by computer, and postoperative elbow joint function was evaluated using Bellemore criteria. All measurement data were presented as means ± SD, and Student's t test was used to examine differences between groups. All count data between both groups were compared using the chi-square test or Fisher's exact test analysis. Results: All individualized navigation templates matched well with the corresponding anatomical markers and were consistent with preoperative planning, simulated surgery, and intraoperative procedures. Average operation times from clear exposure to fixed Kirschner wire were 11.69 min (9.6-13.5 min) for the individualized navigation template group and 22.89 min (17.7-26.8 min) for the traditional operation group (p < 0.001). Average differences in postoperation carrying angles between affected and healthy sides were 1.13°(0-2.0°) and 4.21°(0-7.5°), respectively (p < 0.001). Follow-up 6-12 months postoperation showed that elbow function did not differ significantly between groups using the Bellemore criteria (p > 0.05). Conclusions: Individualized navigation templates simplify procedures, reduce operation time, and improve accuracy when used in orthopedic surgery to treat children with cubitus varus deformity.

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Section: Introductionmentioning

confidence: 99%

“…Lateral wedge osteotomies are performed most commonly [2]. This technique is more simple, effective, and reproducible than other osteotomy styles, such as dome osteotomy and multiplanar osteotomy.…”

Section: Introductionmentioning

confidence: 99%

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

Hu¹,

Zhong²,

Lou

et al. 2020

J Orthop Surg Res

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“…Numerous osteotomy techniques have been described, most of which focus on realignment in the coronal and sagittal planes. 12 Complications for traditional corrective osteotomies are reported in the literature to be as high as 50%. 13 Reported complications include ulnar-nerve palsy, hematoma, cosmetically unacceptable scarring, measurable arm atrophy, and loss of correction.…”

Section: Discussionmentioning

confidence: 99%

Outerbridge-Kashiwagi Procedure for the Treatment of a Supracondylar Humerus Fracture Malunion (O-K Procedure)

Alrabaa

Simhon

Kadiyala

2020

Arthroscopy Techniques

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The Outerbridge-Kashiwagi (O-K) procedure has conventionally been used for the treatment of osteoarthritis of the elbow and to treat posttraumatic sequelae including posttraumatic arthritis, stiffness, contracture, and ulnar neuritis. The procedure involves exposure of the posterior elbow joint as well creating a window posteriorly through the olecranon fossa to target anterior aspects of the elbow. Several case series have shown the O-K procedure to have good functional outcomes with minimal complications. Used mostly for the surgical treatment of adult osteoarthritis, the O-K procedure has not been previously described for the treatment of a pediatric supracondylar humerus fracture malunion. This article and accompanying video will present the pearls and discuss the technique of the O-K procedure used to treat the loss of elbow flexion as a sequelae of supracondylar humerus fracture malunion.

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“…Posttraumatic elbow and forearm deformity can occur after either non-operative or operative treatment of acute fractures, as well as following deformity correction surgery (iatrogenic); it presents as impairment of function that is often exacerbated during growth [1]. While the most common deformity at the elbow, varus deformity, was seen for many years as a "purely" cosmetic problem, recent publications and the observation in the authors' multidisciplinary group from Hamburg, Düsseldorf, and Markgröningen, Germany, have shown that longstanding varus deformity of the elbow can lead to ulnar neuritis, medial instability, and functional impairment of the affected upper extremity [3][4][5][6][7]. Nonunion of the radial or ulnar condyle leads to severe arthrosis of the affected elbow joint, resulting in pain, loss of motion, and handicap in daily life and professional activities [8].…”

Section: Examining the Patient Analyzing The Deformity And Informedmentioning

confidence: 99%

“…d Three-dimensional osteotomy: dotted lines represent the planned osteotomies, which are made using preformed patient-specific cutting guides. (Modified from [6]. With courtesy of Elsevier) Fig.…”

Section: Correcting Chronic Radial Head Dislocation (Missed Monteggiamentioning

confidence: 99%

Korrekturosteotomie des distalen Humerus und Unterarms – eine praktische Übersicht

et al. 2019

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Complex deformities of the distal humerus and forearm of either posttraumatic or hereditary origin have a significant negative impact on the functional integrity of the affected limb. They lead to pain, instability in both the elbow and the proximal/distal radioulnar joint, and profound motion deficit. Corrective procedures and more advanced surgical interventions for the main index procedures at the proximal forearm are extremely challenging for the treating upper extremity specialist due to the complex pathoanatomy in this region. This practical review focuses on the main aspects of correcting deformities of the distal humerus (malunion and non-union), the proximal forearm (differential therapy of chronic radial dislocation in children and adolescents), and the restoration of forearm rotation using rapid prototyping templates and computerized planning as the evolving standard technique in this region. In addition to the technical aspects, focus is put on planning (conventional vs. modern computerized three-dimensional (3D) planning), on different osteotomy techniques, and the surgical armamentarium that the specialist center should have available. Finally, some light is shed on the long-term outcome that can be expected and possible complications that can occur when performing these complex corrective procedures.

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Surgical Correction of Cubitus Varus

Cited by 35 publications

References 16 publications

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

Outerbridge-Kashiwagi Procedure for the Treatment of a Supracondylar Humerus Fracture Malunion (O-K Procedure)

Korrekturosteotomie des distalen Humerus und Unterarms – eine praktische Übersicht

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