Corrective osteotomy for the management of varus deformity and malunion after medial condylar fracture

Background and Aim: Cubitus varus deformity is the most common late complication aftersupracondylar fracture of the distal humerus in children, incidence varying from 4% to 58%. Thepresent study was done to evaluate the results of dome osteotomy. Material and Methods: Thisprospective study was conducted in a tertiary care hospital over 16 months. In all patients humerus-elbow wrist angle was measured on both sides and the correction needed was calculated. The lateralcondyle prominence index (LCPI) was calculated by anteroposterior view radiographs of thedeformed and the normal elbow in full extension by (AB-BC)/AC. Dome osteotomy with para tricepsapproach was used. Pre and post-operative carrying angle of elbow, range of motion and lateralprominence indices were compared. Results: The age of patients ranged from 3 to 15 years with amean age of 8.47±3.14 years. Preoperative carrying angle of normal side ranged from 80 to 140and that of effected side ranged from -23 to -13 and the difference was statistically significant(p<0.05). LCPI ranged from -8.4 to 5.9%. The majority of cases had LCPI >2.7%. As compared to,an improvement in carrying angle at defect side was observed to be 28.41±2.15 which wassignificant (p<0.05). At baseline mean LCPI was 0.39±3.87% which changed to -0.86±3.47%, themean change of this was significant (p=0.01). baseline Conclusion: Dome osteotomy is a relativelytechnically demanding technique for correction of cubitus varus deformity but with a betterfunctional outcome without being associated with lateral condyle prominence.

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Peri-talar Osteotomy as Part of Treatment of Talar Osteochondral Defect of Varus Ankle

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000083 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0000

Author(s):

Bibo Wang

Keyword(s):

Osteochondral Defect ◽

Corrective Osteotomy ◽

Varus Deformity ◽

Lateral View ◽

Hindfoot Alignment ◽

Routine Treatment ◽

Vas Score ◽

Radiographic Parameters ◽

Sf36 Score ◽

Double Osteotomy

Category: Ankle Introduction/Purpose: The etiology of osteochondral defect (OCD) of talus is not fully understood. Besides trauma, malalignment of ankle or hindfoot may play a role in the development of OCD. The aim of this study is to assess the efficacy of peri-talar osteotomy in addition to routine treatment of OCD of talus. Methods: This is a retrospective study of 52 cases of varus talar OCD during the period of 2009.9 to 2014.12. Micro-fracture or autograft transplantation were applied for the OCD first according to the dimension of the lesion in all cases. Then peri-talar osteotomy were performed to correct ankle or hindfoot mal-alignment in 26 cases according to the position of varus deformity, including 18 supramalleolar osteotomy, 6 calcaneal osteotomy and 2 combined distal tibial and calcaneal double osteotomy. Pre- and post-operative radiographic parameters of TAS, TTS, TLS angles and MoA were measured on mortise view, lateral view and hindfoot alignment view respectively. AOFAS-AH score, VAS score and SF36 score were performed to assess both subjective and objective outcome. Results: For the osteotomy group, there were statistically changes (P < 0.05) radiographically (TAS, TTS, MoA, TLS) after surgery. While the radiographic parameters didn’t change in the group without corrective osteotomy. AOFAS-AH score and VAS score increased significantly (P < 0.05) in both the osteotomy group and the non-osteotomy group. The SF36 scores score increased significantly (P < 0.05) in the osteotomy group while not significant in the non-osteotomy group. The AOFAS-AH and SF36 scores were statistically higher in the osteotomy group after surgery (p<0.05), and the VAS score were not statistically different in two groups. There were 5 out of 26 revised cases in the non-osteotomy group while 2 out of 26 revised cases in the osteotomy group. Conclusion: Peri-talar osteotomy in addition to routine treatment of OCD of talus results in better radiographic and functional outcome and lower recurrence for patients of varus talar osteochondral defect. Mechanical malalignment may contribute to progression of OCD of talus and thus should be corrected simultaneously.

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Characteristics of Cubitus Varus Deformity after Lateral Condylar Fracture of the Humerus

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835521500211 ◽

2021 ◽

Author(s):

Takehiko Takagi ◽

Yuki Bessho ◽

Atsuhito Seki ◽

Shinichiro Takayama

Keyword(s):

Varus Deformity ◽

Cubitus Varus ◽

Condylar Fracture

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Preoperative, Computer Simulation-Based, Three-Dimensional Corrective Osteotomy for Cubitus Varus Deformity with Use of a Custom-Designed Surgical Device

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.l.01622 ◽

2013 ◽

Vol 95 (22) ◽

pp. e173 ◽

Cited By ~ 52

Author(s):

Yukari Takeyasu ◽

Kunihiro Oka ◽

Junichi Miyake ◽

Toshiyuki Kataoka ◽

Hisao Moritomo ◽

...

Keyword(s):

Computer Simulation ◽

Corrective Osteotomy ◽

Three Dimensional ◽

Varus Deformity ◽

Cubitus Varus ◽

Simulation Based ◽

Surgical Device

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Corrective Osteotomy for Cubitus Varus Deformity

Journal of Pediatric Orthopaedics ◽

10.1097/01241398-199407000-00012 ◽

1994 ◽

Vol 14 (4) ◽

pp. 487-491 ◽

Cited By ~ 31

Author(s):

Miguel A. Hernandez ◽

James W. Roach

Keyword(s):

Corrective Osteotomy ◽

Varus Deformity ◽

Cubitus Varus

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Three-Dimensional Corrective Osteotomy for Cubitus Varus Deformity with Use of Custom-Made Surgical Guides

JBJS Essential Surgical Techniques ◽

10.2106/jbjs.st.m.00044 ◽

2014 ◽

Vol 4 (1) ◽

pp. e6 ◽

Cited By ~ 3

Author(s):

Tsuyoshi Murase ◽

Yukari Takeyasu ◽

Kunihiro Oka ◽

Toshiyuki Kataoka ◽

Hiroyuki Tanaka ◽

...

Keyword(s):

Corrective Osteotomy ◽

Three Dimensional ◽

Varus Deformity ◽

Cubitus Varus ◽

Surgical Guides ◽

Custom Made

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Treatment of pes varus using locking plate fixation in seven Dachshund dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-11-03-0035 ◽

2012 ◽

Vol 25 (03) ◽

pp. 231-238 ◽

Cited By ~ 4

Author(s):

T. Nicetto ◽

A. Vezzoni ◽

A. Piras ◽

R. Palmer ◽

M. Petazzoni

Keyword(s):

Locking Plate ◽

Corrective Osteotomy ◽

Distal Tibia ◽

Varus Deformity ◽

Wedge Osteotomy ◽

Opening Wedge ◽

Implant Complications ◽

Radiographic Measurements ◽

Locking Plate System ◽

Plate System

SummaryObjectives: To describe the surgical treatment of pes varus in Dachshund dogs by medial opening wedge osteotomy of the distal tibia stabilized with a locking plate system and to retrospectively report the clinical and radiographic outcomes.Materials and methods: Lameness in nine limbs of seven Dachshund dogs with pes varus deformity was treated with corrective osteotomy at or near the centre of rotation of angulation as defined by the intersection of the proximal and distal mechanical axes determined on caudo-cranial radiographs. Outcomes evaluated included comparison of preand postoperative radiographic measurements of frontal angulation and lameness assessment.Results: Lameness resolved in eight limbs and improved in one limb. All osteotomies healed and no implant complications were detected. Mean preoperative radiographic measurements were: mechanical medial proximal tibial angle (mMPTA) = 91.1° (range 87.6°-95°), mechanical medial distal tibial angle (mMDTA) = 62.1° (range 51.9°-69.6°). Mean postoperative measurements were: mMPTA 92.4° (range 78°-97.5°), mMDTA 81.8° (range 76°-87°). Measurable undercorrection was common, though seldom visually or functionally evident.Clinical significance: Pes varus deformity in Dachshunds can be treated by medial opening wedge osteotomy of the distal tibia stabilized with a locking plate system. Care to preserve the lateral cortex of the osteotomy may help avoid under-correction.

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