J Korean Orthop Assoc.  2008 Feb;43(1):17-23. 10.4055/jkoa.2008.43.1.17.

Lateral Closing Wedge Supracondylar Osteotomy of the Humerus in Children with Cubitus Varus Deformity

• Shim JS
• Sul E
• Ha H
• Kim CY

• KMID: 2106411
• DOI: http://doi.org/10.4055/jkoa.2008.43.1.17

Abstract

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.

Keyword

Cubitus varus; Lateral condylar prominence; Osteotomy

MeSH Terms

Child
Congenital Abnormalities
Cosmetics
Follow-Up Studies
Humans
Humerus
Osteotomy
Cosmetics

Figure

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  Fig. 1 (A) Lateral closing wedge osteotomy was performed. (B) Lazy 'S' deformity was observed on the radiograph of two months after the operation.

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  Fig. 2 (A) Humero-ulnar angle was measured on the anteroposterior radiograph of the elbow. (B) Shaft-condylar angle was measured on the lateral radiograph of the elbow.

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  Fig. 3 (A) The angle of cubitus varus deformity was measured intraoperatively with C-arm fluoroscopy. (B) The operation was performed through a lateral approach. (C) We used two preset Kirschner's wires. (D) Osteotomized site was fixed with Steinmann pins. (E) Cubitus varus was corrected after surgery.

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  Fig. 4 (A) Lateral prominence index (LPI) is BC/AB. (B) Lateral prominence amount (LPA) is BC/AC × 100 (%).

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  Fig. 5 (A) A six-year-old boy had the varus humeroulnar angle of 33° on the preoperative radiograph. (B) On the immediate postoperative radiograph, LPI was 3.23 and LPA was 45.3 percent. (C) On the radiograph after a 4-year-follow-up, the LPI was 1.01, and the LPA was zero percent.

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  Fig. 6 Lateral prominence amount decreased with the increasing follow-up duration.

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  Fig. 7 The change in the amount of lateral prominence diminished with increasing age when the operation had been performed.

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