DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20211600

Outcome of three dimensional osteotomy for cubitus varus deformity

Krishna Priya Das, Nakul Kumar Datta, Mohammad Zahidulhak Khan, Jahidul Islam, Rumpa Mani Chowdhury

Abstract


Background: Cubitus varus is the most common angular deformity resulting from supracondylar fracture of the humerus in children and adults. There are several options for correcting this deformity, but three dimensional osteotomy is now a popular method for the operative treatment of cubitus varus deformity. Objective of current study was to evaluate clinical and radiological outcome of three dimensional corrective osteotmy for cubitus varus deformity.

Methods: This prospective interventional study was conducted in the department of orthopaedic surgery, BSMMU, Shahbag, Dhaka from January 2016 to September 2020. Within this period, total 40 cases of cubitus varus deformity, age ranging from 8-20 years that has the inclusion criteria was enrolled as a study sample with proper consent. All the data were analyzed statistically by using SPSS-22.

Results: The results of present study showed significantly improved carrying angle, range of motion, internal rotation angle at the time of final follow-up period of six months or more. The outcome of the subjects was graded as excellent in 16 (40%), good in 18 (45%), fair in 4 (10%) and poor in 2 (5%) patients. Excellent, good and fair results were considered as satisfactory outcome and only poor result was considered as unsatisfactory outcome.

Conclusions: After analyzing the results of present study it can be concluded that three dimensional osteotomy is a safe technique with satisfactory outcome in treatment of cubitus varus deformity.


Keywords


Outcome, Osteotomy, Cubitus varus, Deformity

Full Text:

PDF

References


Crombie A, Duncan R. Closed reduction and percutaneous fixation of displaced paediatric supracondylar fractures of the elbow. Curr Orthopaed. 2004;18(2):147-53.

Steenbrugge F, Macnicol MF. Guidelines and pitfalls in the management of supracondylar humerus fractures in children. Curr Orthopaed. 2001;15(3):214-9.

Pirone AM, Graham HK, Krajbich JI. Management of displaced extension-type supracondylar fractures of the humerus in children. J Bone Joint Surg. 1988;70(5):641-50.

Azar FM, Beaty JH, Canale ST. Campbelle’s operative orthopedics, 13th ed; Canada: Elsevier press; 2017:2;1439-40.

Louw FM. Neurovascular complications after supracondylar humerus fractures in children. Trauma Case Rep. 2017;8:16-9.

Jain AK, Dhammi IK, Arora A, Singh MP, Luthra JS. Cubitus varus: problem and solution. Arch Orthopaed Trauma Surg. 2000;120(7-8):420-5.

Vashisht S, Sudesh P, Gopinathan NR, Kumar D, Karthick SR, Goni V. Results of the modified reverse step-cut osteotomy in paediatric cubitus varus. Int Orthopaed. 2020;44:1417-26.

Solfelt DA, Hill BW, Anderson CP, Cole PA. Supracondylar osteotomy for the treatment of cubitus varus in children: a systematic review. Bone Joint J. 2014;96(5):691-700.

Usui M, Ishii S, Miyano S, Narita H, Kura H. Three-dimensional corrective osteotomy for treatment of cubitus varus after supracondylar fracture of the humerus in children. J Shoulder Elbow Surg. 1995;4(1):17-22.

Yun YH, Shin SJ, Moon JG. Reverse V osteotomy of the distal humerus for the correction of cubitus varus. J Bone Joint Surg. 2007;89(4):527-31.

French PR. Varus deformity of the elbow following supracondylar fractures of the humerus in children. Lancet. 1959;274(7100):439-41.

Bellemore MC, Barrett IR, Middleton RW, Scougall JS, Whiteway DW. Supracondylar osteotomy of the humerus for correction of cubitus varus. J Bone Joint Surg. 1984;66(4):566-72.

Fernandez DL. Reconstructive procedures for malunion and traumatic arthritis. Orthoped Clin North Am. 1993;24(2):341-63.

Bilic R, Zdravkovic V, Boljevic Z. Osteotomy for deformity of the radius.Com puter-assisted three-dimensional modelling. J Bone Joint Surg Br. 1994; 76:150-4.

Uchida Y, Ogata K, Sugioka Y. A new three-dimensional osteotomy for cubitus varus deformity after supracondylar fracture of the humerus in children. J Pediatr Orthoped. 1991;11(3):327-31.

King D, SECOR C. Bow elbow (cubitus varus). JBJS. 1951;33(3):572-6.

Rang M. Children’s fractures. Philadelphia: JB Lippincott Company. 1974:1278-94.

Sweeney JG. Osteotomy of the humerus for malunion of supracondylar fractures. J Bone Joint Surg. 1975; 57:117.

Uchida Y, Ogata K, Sugioka Y. A new three-dimensional osteotomy for cubitus varus deformity after supracondylar fracture of the humerus in children. J Pediatr Orthoped. 1991;11(3):327-31.

Chung MS, Baek GH. Three-dimensional corrective osteotomy for cubitus varus in adults. J Shoulder Elbow Surg. 2003;12(5):472-5.

Ippolito E, Moneta MR, d'Arrigo C. Post-traumatic cubitus varus. Long-term follow-up of corrective supracondylar humeral osteotomy in children. J Bone Joint Surg. 1990;72(5):757-65.

Davids JR, Lamoreaux DC, Brooker RC, Tanner SL, Westberry DE. Translation step-cut osteotomy for the treatment of posttraumatic cubitus varus. J Pediatr Orthoped. 2011;31(4):353-65.

Murase T, Oka K, Moritomo H, Goto A, Yoshikawa H, Sugamoto K. Three-dimensional corrective osteotomy of malunited fractures of the upper extremity with use of a computer simulation system. J Bone Joint Surg. 2008;90(11):2375-89.

Takagi T, Takayama S, Nakamura T, Horiuchi Y, Toyama Y, Ikegami H. Supracondylar osteotomy of the humerus to correct cubitus varus: do both internal rotation and extension deformities need to be corrected?. J Bone Joint Surg. 2010;92(7):1619-26.

Takeyasu Y, Murase T, Miyake J, Oka K, Arimitsu S, Moritomo H, et al. Three-dimensional analysis of cubitus varus deformity after supracondylar fractures of the humerus. J Shoulder Elbow Surg. 2011;20(3):440-8.

Sath S, Shah NA, Peerzada MS. Observations on the correction of cubitus varus post supracondylar fracture of humerus by lateral closed wedge osteotomy and plating in adolescents and adults: A case study of 12 patients. IJOS. 2015;2(1):1-5.

Bali K, Sudesh P, Krishnan V, Sharma A, Manoharan SR, Mootha AK. Modified step-cut osteotomy for post-traumatic cubitus varus: our experience with 14 children. Orthopaed Traumatol Surg Res. 2011;97(7):741-9.

Suchinder A, Chittaranjan K, Venkatesh D. A study of functional outcome of correction of cubitus varus deformity by stepcut translation osteotomy. Int J Orthopaed. 2017;3(4):274-84.

Pandey S, Shrestha A, Dhakal S, Neupane G, Regmi AP. Cubitus varus in adults correction with lateral closing wedge osteotomy and fixation with posterior plating. J Coll Med Sci. 2012;8(2):49-53.

Takeyasu Y, Oka K, Miyake J, Kataoka T, Moritomo H, Murase T. Preoperative, computer simulation-based, three-dimensional corrective osteotomy for cubitus varus deformity with use of a custom-designed surgical device. J Bone Joint Surg. 2013;95(22):e173.

Kumar D, Singh S, Kumar S, Srikant TH, Rai T. Clinical Outcome of Dome Osteotomy in Cubitus Varus. MOJ Orthop Rheumatol. 2014;1(4):1-5.

Langenskiöld A, Kivilaakso R. Varus and valgus deformity of the elbow following supracondylar fracture of the humerus. Acta Orthopaedica Scandinavica. 1967;38(1-4):313-20.