The lateral curved osteotomy for cubitus varus deformity in children: A case report and literature review

Abstract

Introduction Cubitus varus deformity after malunited supracondylar humerus fracture has various surgical techniques, implant configurations, and approaches. We describe a combination of French and Dome osteotomy and novel internal fixation technique to deliver an easy, safe, fast and reproducible result based on the current best evidence. Presentation of case Two cases of malunited supracondylar humerus are described. The first case involves a 3-year-old girl who presented with outstretched and supinated left arm after falling during bike riding 3 weeks earlier. We found no abnormality in radial and median nerve function, but the left arm radiographs showed a callus formation and the early stages of a malunited fracture of the supracondylar humerus. We waited two months for further radiographic evaluation and the radiographs showed the malunited supracondylar humerus with elbow flexion of only 105° and elbow hyperextension of 20°. The cubitus varus was recorded with clinical carrying angle of varus 10°. We used a combination of original French and Dome osteotomy, lateral approach, and our novel fixation technique with excellent results. The second case involved a 8-year-old boy with malunited right elbow and the surgery was done in the same manner, with the result of restoration to normal elbow range of motion. We also assessed the pain score and disabilities of the arm, shoulder and hand (DASH) score and recorded satisfactory results. Conclusions The combination of French and Dome osteotomy for treatment of cubitus varus deformity can provide an easy, safe, and reproducible result.

Distal humeral corrective osteotomy for treatment of supracondylar fracture malunions in children

“…Nevertheless, the results and level of evidence have been inconsistent to date. 7 Complications of SCH fractures are fairly prevalent and include neurovascular injuries, compartment syndrome, restricted range of motion, and posttraumatic deformities. 8 Numerous anatomic components of SCH malunions have been documented, including elbow varus deformity, elbow hyperextension, and internal malrotation.…”

“… 8 The frequency of cubitus varus deformity secondary to SCH fractures ranges from 3% to 57%. 7 It not only results in an unfavorable aesthetic deformity of the elbow, but may also increase the incidence of lateral condyle fractures, internal rotational malalignment, elbow discomfort and dysfunction, and other secondary fractures. 8 In contrast, isolated extension deformity is associated with a high remodeling rate in younger children.…”