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OBJECTIVE@#To investigate the clinical efficacy of picture archiving and communication system (PACS) and Photoshop assisted isosceles triangle osteotomy and Kirschner wire fixation with tension band in the treatment of cubitus varus in children.@*METHODS@#The clinic data of 20 children with cubitus varus treated with isosceles triangle osteotomy of distal humerus and Kirschner wire fixation with tension band from October 2014 to October 2019, were retrospectively analyzed. There were 13 males and 7 females, aged from 3.2 to 13.5 years old, the median age was 6.65 years old. PACS system was applied for the osteotomy design preoperatively, simulating and measuring the side length of isosceles triangle osteotomy. Then, Photoshop system was used to simulate the preoperative and postoperative osteotomy graphics, which could guide precise osteotomy during operation.@*RESULTS@#All the 20 patients were followed up for 20 to 24 months, with a median of 22.5 months. At the last follow-up, the carrying angle of the affected limb was 5 ° to 13 °, with a median of 8.3 °. The clinical efficacy was evaluated according to the Flynn elbow function score:excellent in 16 cases, good in 2 cases, and fair in 2 cases.@*CONCLUSION@#The treatment of cubitus varus in children by isosceles triangle osteotomy and Kirschner wire fixation with tension band assisted by PACS and Photoshop system has shown good clinical outcome.
Subject(s)
Male , Female , Humans , Child , Child, Preschool , Adolescent , Humeral Fractures/surgery , Bone Wires , Retrospective Studies , Humerus/surgery , Treatment Outcome , Elbow Joint/surgery , Osteotomy , Joint Deformities, Acquired/surgery , Range of Motion, ArticularABSTRACT
OBJECTIVE@#To explore the feasibility and early effectiveness of computer-simulated osteotomy based on the health-side combined with guide plate technique in the treatment of cubitus varus deformity in adolescents.@*METHODS@#The clinical data of 23 patients with cubitus varus deformity who met the selection criteria between June 2019 and February 2023 were retrospectively analyzed. There were 17 males and 6 females, ranging in age from 4 to 16 years with an average of 8.5 years. The time from injury to operation was 1-4 years. The angle of distal humerus rotation was defined by humeral head posterior inclination angle using low radiation dose CT to scan the patient's upper extremity data at one time, and the preoperative rotation of the distal humerus on the affected side was (33.82±4.39)°. The CT plain scan data were imported into 9yuan3D digital orthopaedic system (V3.34 software) to reconstruct three-dimensional images of both upper extremities. The simulated operation was performed with the healthy upper extremity as the reference, the best osteotomy scheme was planned, overlapped and compared, and the osteotomy guide plate was prepared. The patients were followed up regularly after operation, and the formation of callus in the osteotomy area was observed by X-ray examination. Before and after operation, the carrying angle of both upper extremities (the angle of cubitus valgus was positive, and the angle of cubitus varus was negative) and anteversion angle were measured on X-ray and CT images. At the same time, the flexion and extension range of motion of elbow joint and the external rotation range of motion of upper extremity were measured, and Mayo score was used to evaluate the function of elbow joint.@*RESULTS@#The operation time ranged from 34 to 46 minutes, with an average of 39 minutes. All patients were followed up 5-26 months, with a mean of 14.9 months. All the incisions healed by first intention after the operation; 2 patients had nail path irritation symptoms after Kirschner wire fixation, which improved after dressing change; no complication such as breakage and loosening of internal fixators occurred after regular X-ray review. Continuous callus formed at the osteotomy end at 4 weeks after operation, and the osteotomy end healed at 8-12 weeks after operation. At last follow-up, the carrying angle, anteversion angle, external rotation range of motion, and extension and flexion range of motion of the elbow joint of the affected side significantly improved when compared with preoperative ones ( P<0.05). Except for the extension range of motion of the healthy elbow joint ( P<0.05), there was no significant difference in other indicators between the two sides ( P>0.05). At last follow-up, the Mayo elbow score was 85-100, with an average of 99.3; 22 cases were excellent, 1 case was good, and the excellent and good rate was 100%.@*CONCLUSION@#Computer-simulated osteotomy based on health-side combined with guide plate technique for treating cubitus varus deformity in adolescents can achieve precise osteotomy, which has the advantages of short operation time and easy operation, and the short-term effectiveness is satisfactory.
Subject(s)
Male , Female , Humans , Adolescent , Child, Preschool , Child , Elbow , Humeral Fractures/surgery , Retrospective Studies , Joint Deformities, Acquired/surgery , Elbow Joint/surgery , Limb Deformities, Congenital , Osteotomy/methods , Humeral Head , Range of Motion, Articular , Computers , Treatment OutcomeABSTRACT
Objective:To evaluate the clinical outcomes of neutral wedge osteotomy assisted by determination of the center of rotation of angulation (CORA) at the distal humerus anatomical axis for cubitus varus deformity in children.Methods:From 2016 to December 2019, 20 children with cubitus varus after supracondylar fracture of the humerus were treated at Department of Orthopeadics, Children's Hospital of Wujiang District. They were 8 boys and 12 girls, aged from 4 to 12 years (average, 7.0 years). Standard anteroposterior X-ray films of bilateral humerus were taken preoperatively for measurement of Baumann angle, proximal anatomical axis (PAA) and distal anatomical axis (DAA) of bilateral humerus to determine the CORA and the varus deformity angle. A lateral closed neutral wedge osteotomy was performed around the CORA to correct the varus deformity. All children were immobilized with elbow plaster cast after operation. Elbow flexion and extension function, postoperative scar, and body surface carrying angle were recorded. The carrying angle and Baumann angle were also measured on elbow X-ray films. Elbow function was evaluated according to the modified Flynn elbow score at 24 months after operation.Results:All patients were followed up for 24 to 36 months (mean, 29.3 months). Elbow hyperextension was close to normal in 18 cases, and 5° hyperextension existed in 2 cases. The flexion was greater than 130°, averaging 133.1° (from 130° to 138°), in 15 patients. The flexion ranged from 110° to 130° in 5 patients. The Baumann angle was 99.0°±1.0° preoperatively and 76.0°±1.0° postoperatively; the carrying angle was -14.0°±1.0° preoperatively and 13.6°±1.0° postoperatively. There were significant differences between the above items between preoperation and postoperation ( P<0.05). According to the modified Flynn elbow score at 24 months after operation, the elbow function was excellent in 16 and good in 4 cases. The varus of 40° was corrected during surgery in one child. Fixation failure or correction failure occurred in none of the children before removal of the plaster or the Kirschner wire. Conclusions:In neutral wedge osteotomy assisted by determination of the CORA at the distal humerus anatomical axis, the CORA and angulation of the distal humerus inversion can be accurately determined so that the osteotomy line and the angulation correction axis can pass through the CORA to restore the humerus alignment with no displacement of the broken ends.
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Objective To investigate the feasibility and clinical effectiveness of modified humeral supracondy-lar step－cut osteotomy(M－HSSCO)for cubitus varus in children.Methods Between June 2016 and June 2017,the study included 25 children (20 boys and 5 girls)presenting cubitus varus at the age of (8.5 ± 0.3)years old (6－11 years old)in the Children's Hospital of Nanjing Medical University.M－HSSCO was used in the osteotomy operation. The initial osteotomy was performed as a right triangle osteotomy.The inferior margin of this right triangle was outlined parallel to the joint line 0.5－1.0 cm above the olecranon fossa.Then,they were incised from the medial end of this parallel line,which made an angle between the first and second lines equal to the desired corrective humerus elbow－wrist angle.Next,from the lateral end of the second line,the third line perpendicular to the first line was cut.Finally, desired right triangle was outlined and removed.The second right triangle osteotomy from proximal line of osteotomy was similar as the above.The medial cortex and periosteum was used as a hinge and rotated to make two osteotomy parts combined steadily.The Bellemore evaluation system was used to evaluate the difference in carrying angle degree be-tween the affected side and normal side after osteotomy,and the different degree of flexion and extension in the elbow joint between preoperation and post－operation.Residual varus deformity and other complications were also evaluated. Results All patients were followed up for 6－18 months (mean 12 months).The preoperative ipsilateral carrying an-gle was－(15°－30°)[－(22.20 ± 1.40)°],the postoperative was 5°－10°[(7. 60 ± 0.47)°]and the final follow－up was 5°－9°[(7.30 ± 0.40)°].There were statistically significant differences in the flexion angles before surgery and after surgery (t＝23.34,P＝0.000).There were statistically significant differences in the flexion angles before surgery and at final follow－up (t＝23.14,P＝0.000).The mean range of joint motion of the elbow was －5°－130° [(132.5 ± 0.5)°]before surgery,0°－125°[(123.6 ± 1.4)°]after surgery and 0°－130°[(126.8 ± 1.3)°]at fi-nal follow－up.The carrying angle reduced did not happen by the final follow－up.There was no statistically significant difference between the flexion angles before surgery and after surgery or by final follow－up(P＞0. 05).Twenty－three (92.0%)patients got an excellent result,2 cases(18.0%)got a good result and no patient (0)got worse according to the criteria described by Bellemore.The first－class incision healing were achieved in all patients.There was no case with postoperative infection,instabilities,vascular and neural injury or any significant postoperative complications. Conclusions M－HSSCO is an effective osteotomy procedure which shows good feasibility and apparent therapeutic effect in treating cubitus varus in children.
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Objective To investigate application of modified isosceles triangle osteotomy which is designed with the assistance of Picture Archiving and Communication System ( PACS ) in supracondylar surgery for cubitus varus. Methods We reviewed the 31 patients who had been treated for cubitus varus from January 2012 to July 2017. They were 12 males and 19 females, aged from 17 to 24 years ( average, 20. 6 years) . Their elbow varus angles ranged from 14° to 35° (average, 22. 4°) . Preoperatively, the modified isosceles triangle osteotomy was designed using the PACS. The angle of osteotomy = carrying angle of the normal arm + the angle of cubitus varus. The lateral length of the isosceles triangle osteotomy was calculated according to the osteotomy angle. All the cases were fixated with a locking plate. Results The follow-ups lasted from 12 to 40 months ( average, 16 months ) . Bony union was achieved in the osteotomy site by all cases after 7 to 12 weeks ( average, 9 weeks ) . The carrying angles ranged from 8° to 15° ( average, 11°) at final follow-ups. The affected elbow obtained a range of flexion and extension from 126° to 150° ( average, 139°) and a range of rotation from 134° to 160° ( 144°) . According to the Mayo elbow performance score ( MEPS ) one year after operation, 23 cases were rated as excellent, 7 as good and one as fair, yielding an excellent to good rate of 96. 8％. No loss of carrying angle, neural deficit, malunion, delayed union, or myositis ossifi-cans of the elbow was observed during the follow-ups. Conclusion The PACS can be used in preoperative design of the modified isosceles triangle osteotomy for cubitus varus, leading to accuracy in the angle and length of the osteotomy to guarantee fine clinical results.
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<p><b>OBJECTIVE</b>To further investigate the risk factors of cubitus varus in humeral condylar fracture after conservative treatment in children through Logistic regression analysis, so as to guide the clinical treatment.</p><p><b>METHODS</b>Children with humeral condylar fracture who were treated by manipulative reduction and plaster fixation in our hospital from March 2008 to December 2014 were studied. The clinical data including age, gender, BMI, time from injury to reduction, direction of displacement, rotation displacement, fixed position, and epiphyseal injury were collected. First, preliminary screen the risk factors through univariate analysis of the above data, then determine the risk factors of cubitus varus through multivariate Logistic regression analysis of the significant factors from univariate analysis.</p><p><b>RESULTS</b>Univariate analysis showed that time from injury to reduction, direction of displacement, rotation displacement and epiphyseal injury were significantly correlated with the cubitus varus. Multivariate Logistic regression analysis showed that time from injury to reduction which was longer than 8 h [=0.017, OR=3.303(1.243-8.774)], ulnar displacement [=0.001,=11.951(2.895-49.335)], rotation displacement [=0.003, OR=4.190(1.643-10.685)]and epiphyseal injury [=0.000,=7.092(2.557-19.671)] were independent risk factors of cubitus varus.</p><p><b>CONCLUSIONS</b>Time from injury to reduction, ulnar displacement, rotation displacement and epiphyseal injury are independent risk factors of cubitus varus. So it need corresponding treatment according to different risk factors.</p>
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BACKGROUND: Cubitus varus and cubitus valgus deformities are common complications of distal humeral fractures in children. We evaluated the usefulness of supracondylar dome osteotomy as a treatment option for adults with cubitus varus or valgus deformity developed during childhood. METHODS: Ten patients who had received supracondylar dome osteotomy and stabilization with plates to treat cubitus varus or valgus deformity between July 2006 and August 2013 were included in this study. Their mean age at the time of surgery was 36.50 ± 10.22 years. The mean follow-up duration was 54.80 ± 32.50 months. We evaluated humerus-elbow-wrist angles (HEWA), improvements in the lateral prominence index (LPI) or medial prominence index (MPI), Mayo elbow performance scores (MEPS), and overall results in accordance with the Banerjee criteria. RESULTS: For the six patients with cubitus varus, the mean postoperative HEWA, mean correction angle, and mean improvement in LPI were 9.72° ± 3.95°, 27.67° ± 10.75°, and 6.92% ± 3.40%, respectively. For the four patients with cubitus valgus, the mean postoperative HEWA, mean correction angle, and mean improvement in MPI were 14.73° ± 2.97°, 11.55° ± 3.26°, and 11.33% ± 6.39%, respectively. There was no significant difference between postoperative and preoperative mean MEPS. The subjective ulnar nerve symptoms were alleviated in all patients. The overall results were excellent in six and good in four patients. CONCLUSIONS: This study suggests that supracondylar dome osteotomy with secure fixation using double plates may be useful in correcting cubitus varus or cubitus valgus deformity, yielding good functional outcomes in adults.
Subject(s)
Adult , Child , Humans , Congenital Abnormalities , Elbow , Follow-Up Studies , Humeral Fractures , Osteotomy , Ulnar NerveABSTRACT
Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months follow-up, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.
Subject(s)
Humans , Young Adult , Congenital Abnormalities , Drainage , Elbow , Follow-Up Studies , Osteotomy , Range of Motion, ArticularABSTRACT
Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months follow-up, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.
Subject(s)
Humans , Young Adult , Congenital Abnormalities , Drainage , Elbow , Follow-Up Studies , Osteotomy , Range of Motion, ArticularABSTRACT
BACKGROUND: Cubitus varus and cubitus valgus deformities are common complications of distal humeral fractures in children. We evaluated the usefulness of supracondylar dome osteotomy as a treatment option for adults with cubitus varus or valgus deformity developed during childhood. METHODS: Ten patients who had received supracondylar dome osteotomy and stabilization with plates to treat cubitus varus or valgus deformity between July 2006 and August 2013 were included in this study. Their mean age at the time of surgery was 36.50 ± 10.22 years. The mean follow-up duration was 54.80 ± 32.50 months. We evaluated humerus-elbow-wrist angles (HEWA), improvements in the lateral prominence index (LPI) or medial prominence index (MPI), Mayo elbow performance scores (MEPS), and overall results in accordance with the Banerjee criteria. RESULTS: For the six patients with cubitus varus, the mean postoperative HEWA, mean correction angle, and mean improvement in LPI were 9.72°± 3.95°, 27.67°± 10.75°, and 6.92% ± 3.40%, respectively. For the four patients with cubitus valgus, the mean postoperative HEWA, mean correction angle, and mean improvement in MPI were 14.73°± 2.97°, 11.55°± 3.26°, and 11.33% ± 6.39%, respectively. There was no significant difference between postoperative and preoperative mean MEPS. The subjective ulnar nerve symptoms were alleviated in all patients. The overall results were excellent in six and good in four patients. CONCLUSIONS: This study suggests that supracondylar dome osteotomy with secure fixation using double plates may be useful in correcting cubitus varus or cubitus valgus deformity, yielding good functional outcomes in adults.
Subject(s)
Adult , Child , Humans , Congenital Abnormalities , Elbow , Follow-Up Studies , Humeral Fractures , Osteotomy , Ulnar NerveABSTRACT
Patients with cubitus varus deformity secondary to malunited supracondylar fracture are at risk for lateral humeral condylar (LHC) fracture. This report describes a child presenting with preexisting malunion of supracondylar fracture presenting along with nonunion of a LHC fracture following a recent injury. The patient underwent resection osteotomy of the metaphyseal proximal fragment of the fracture surface, reduction of the displaced LHC fragment and screw fixation. This procedure corrected the cubitus varus and treated the nonunion of the lateral condyle thus avoiding a supracondylar osteotomy procedure. Treatment resulted in solid union, good range of motion and no avascular necrosis.
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PURPOSE: To analyze the relationship between cubitus varus deformities and rotatory abnormalities after bone union. MATERIALS AND METHODS: A total of 263 patients were diagnosed with Gartland type II supracondylar humerus fractures between May 1996 and May 2003 and underwent surgery. The Gartland method was used to classify the fractures. Of the 263 cases, 141 were type II, and 122 were type III. All patients underwent subcutaneous K-wire fixation after manual reduction except one that showed open radial nerve damage at the time of trauma. A mathematical method was used to evaluate rotation abnormalities in the axial plane. RESULTS: There was no postoperative nonunion or iatrogenic ulnar nerve palsy in 8 cases of cubitus varus deformity. Cubitus varus deformities failed to show a statistically significant correlation with malrotation in the axial plane. CONCLUSION: There was no relationship between rotatory abnormalities after union and cubitus varus deformities.
Subject(s)
Child , Humans , Congenital Abnormalities , Humerus , Radial Nerve , Ulnar NeuropathiesABSTRACT
PURPOSE: To evaluate the effectiveness, cosmetic and functional improvement of a supracondylar lateral closing wedge osteotomy of the humerus as a treatment for cubitus varus deformity in children. MATERIALS AND METHODS: Forty-eight children with cubitus varus underwent a lateral closing wedge osteotomy, and were followed up for at least 1 year. RESULTS: There were no complications such as a loss of correction, infection, or neurapraxia. The immediate postoperative lateral condylar prominence and secondary lazy S deformity was in proportion to the preoperative severity of the cubitus varus. However, it was lower at the last follow-up, and was related to the extent of preoperative cubitus varus, length of follow-up and age. CONCLUSION: A supracondylar lateral closing wedge osteotomy of humerus is an easy and effective surgical treatment for a posttraumatic cubitus varus of children. In addition, it shows good cosmetic results with good remodeling of the lateral condylar prominence of children.
Subject(s)
Child , Humans , Congenital Abnormalities , Cosmetics , Follow-Up Studies , Humerus , OsteotomyABSTRACT
Cubitus varus deformity of the elbow may not only cause cosmetic problems, but delayed functional deficiencies also. This case report demonstrated delayed posterolateral rotatory instability due to lateral collateral ligament complex avulsion long after posttraumatic cubitus varus. Satisfactory results were obtained using cubitus varus correction and reattachment of the lateral collateral ligament complex to the lateral epicondyle of the humerus.
Subject(s)
Congenital Abnormalities , Elbow , Humerus , Lateral Ligament, AnkleABSTRACT
Objective To investigate the treatment of nonunion and cubitus varus after lateral condylar fracture of humerus. Methods 5 cases of nonunion and cubitus varus after lateral condylar fracture of humerus were admitted to my department from January 2001 to June 2003. They were treated with reduction and supracondylar wedge osteotomy. Results They were followed up for 8 months on average. Their nonunion and cubitus varus were all corrected. According to Su Shang-qing’s evaluation system, 4 cases achieved excellent results and 1 good. Conclusion The operative management is simple and effective for nonunion and cubitus varus after lateral condylar fracture of humerus.
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PURPOSE: To define the significant factors for lateral condyle prominence following the lateral closing wedge osteotomy for cubitus varus. MATERIALS AND METHODS: Analyzed the 15 cases performed lateral closing wedge osteotomy for cubitus varus. We measured the carrying angle by the arm and forearm axis lines of soft tissues, lateral condyle prominence index, the distance from center of rotation to osteotomy site and the distance from center of rotation to elbow joint. RESULTS: The lateral condyle prominence group with lateral condyle prominence index (LCPI) over 300% was 5 cases (33%), and no prominence group was 10 cases (67%). The distance between CORA and osteotomy site in lateral condyle prominence group was mean 44 mm (range, 35-52) and no prominence group was mean 21 mm (range, 17-27). The distance between CORA and elbow joint was mean -3 mm (range -15~7) and 16 mm (range, 8-24) respectively. CONCLUSION: Lateral condyle prominence was developed in case of the increased preoperative LCPI, increased distance between CORA and osteotomy site, and decreased distance between CORA and elbow joint.
Subject(s)
Arm , Axis, Cervical Vertebra , Congenital Abnormalities , Elbow Joint , Forearm , OsteotomyABSTRACT
【Objective】External fixation for supracondylar fracture of humerus is improved for the effective prevention of cubitus varus.【Methods】Sixty-eight patients with severe displaced supracondylar fracture of humerus was fixed by medial-lateral splint and elastic rubber ring,with elbow fixed in flexion and supination and near the chest by plaster support.【Results】 The results of follow-up showed that 68 patients were clinically cured,and the rate of cubitus varus was 2.9%,which was lower than that by other methods reported in domestic literatures.【Conclusion】This kind of fixation has the advantages of fixing the fracture firmly,keeping good para-position,preventing rotation displacement,counteracting gravitation-induced ulnar deviation and reducing the occurrence of cubitus varus.
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PURPOSE: evaluate the radiologic and clinical results of modified step-cut osteotomy for correction of cubitus varus deformity in children. MATERIALS AND METHODS: We analysed 16 children who had varus deformity preoperatively and received modified step-cut osteotomy. The results were evaluated by final follow-up radiographs and clinical results, which were humeral-elbow-wrist angle, lateral prominence, range of motion and complications. RESULTS: The average preoperative humeral-elbow-wrist (HEW) angle was -15.8degrees and average last follow-up HEW angle was +6.7degrees Lateral prominence under 5 mm occurred in 3 cases and one children showed limited motion and transient ulna neuropathy. CONCLUSION: The results demonstrate that modified step-cut osteotomy achieve good correction of cubitus varus without lateral bony prominence or complications.
Subject(s)
Child , Humans , Congenital Abnormalities , Follow-Up Studies , Humerus , Osteotomy , Range of Motion, Articular , UlnaABSTRACT
PURPOSE: To analyze the efficiency of simple step-cut translation osteotomy for cubitus varus and valgus deformity of the distal humerus, which was performed using a posterior approach and fixation of a Y-shaped metal plate. MATERIALS AND METHODS: In 20 cases that we were able to observe closely for more than 1year, we classified clinical and radio logical results according to the criteria of Oppenheim and Bellemore. RESULTS: Humerus-Elbow-Wrist angle had been corrected (from 16.6degrees to 7.6degrees in the cubitus varus and from 33.6degrees to 8.3degrees In the cubitus valgus). Change of the lateral and medial prominence index (average 8.38 from -15.74 to -7.36 in the cubitus varus and 7.25 from -17.68 to -10.43 in the cubitus valgus, respectively) provided satisfactory results with decreased protrusion on the medial and lateral condyles. In all cases except one, the range of motion was improved and results were good and excellent. CONCLUSION: Simple step-cut translation osteotomy for the distal humerus obtained very firm fixation with a wedge-shaped osteotomized surface and a Y-shaped metal plate, therefore, early movement was possible. Also because of the dfficiency of the translation osteotomy, we obtained cosmetically satisfactory resullts with a remarkable decreases in protrusion on the medial and lateral condyles.
Subject(s)
Congenital Abnormalities , Humerus , Logic , Osteotomy , Range of Motion, ArticularABSTRACT
PURPOSE: To analyse the result and examine the effectiveness of the operative method. MATERIALS AND METHODS: The authors reviewed 55 osteotomies performed from February 1989 to January 1997. They performed closed-wedge osteotomy by using 2 K-wires and "figure 8"wire loop to correct the cubitus varus deformity. The follow-up period was 22 months in average (5-63 months). RESULT: The mean carrying angle, which was 25 degrees of varus preoperatively, was converted into 6.5 degrees of valgus immediate postoperatively and decreased to 4.6 degrees of valgus at the final follow-up. In range of motion of the elbow, all cases showed full range of motion except one. The mean duration of plaster-cast immobilization after the operation was 2.5 weeks. Fifty-two cases (95%) showed excellent or good results by using the Oppenheim and Bellemore evaluation method. CONCLUSIONS: Closed-wedge osteotomy through lateral approach and fixation by 2 K-wires with "figure 8" wire loop is a safe and satisfactory method having short operating time, stable internal fixation and short immobilization period.