POSTEROLATERAL ROTATORY INSTABILITY OF THE ELBOW AFTER CORRECTIVE OSTEOTOMY FOR PREVIOUSLY ASYMPTOMATIC CUBITUS VARUS DEFORMITY

Background: We identified a subset of patients who had posterolateral rotatory instability (PLRI) following corrective osteotomy for asymptomatic cubitus varus deformity. We aimed to identify risk factors for PLRI in such patients by comparing this subgroup to patients who did not demonstrate PLRI following osteotomy.Methods: We retrospectively reviewed the medical records and radiographs of 22 patients with cubitus varus that underwent corrective osteotomy at our institution between 2003 and 2010. All patients underwent surgery for cosmetic reasons, and no patient reported functional problems such as PLRI or ulnar nerve symptoms pre-operatively. We sought to identify differences between those that experienced an increase in PLRI after osteotomy (PLRI group) and those that did not (non-PLRI group) with regard to demographics, degree of deformity, amount of surgical correction, and final outcomes.Results: Five patients had PLRI after osteotomy, and all five subsequently underwent lateral ulnar collateral ligament reconstruction using a triceps tendon graft. No statistically significant difference was observed between the PLRI and non-PLRI groups in terms of demographics, degree of deformity, amount of surgical correction, range of motion, and final Mayo Elbow Performance Index (MEPI) and the Disabilities of Arm, Shoulder, and Hand (DASH) scores. However, the PLRI group had marginally greater medial displacement of the distal fragment.Conclusions: This study demonstrates that PLRI can become apparent after corrective osteotomy for cubitus varus in the absence of clinical symptoms of instability preoperatively. We suggest that careful examination for PLRI should be performed after surgical correction for cubitus varus deformity, and surgeons should be prepared to proceed with simultaneous reconstruction of the lateral ligaments of the elbow.

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Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1403-7 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 3

Author(s):

Yuan-Wei Zhang ◽

Xin Xiao ◽

Wen-Cheng Gao ◽

Yan Xiao ◽

Su-Li Zhang ◽

...

Keyword(s):

3D Printing ◽

Blood Loss ◽

Three Dimensional ◽

Operation Time ◽

Varus Deformity ◽

Conventional Group ◽

Intraoperative Blood Loss ◽

Cubitus Varus ◽

Guide Plate ◽

Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

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Delayed Posterolateral Rotatory Instability of the Elbow after Cubitus Varus: A Case Report

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2006.41.6.1047 ◽

2006 ◽

Vol 41 (6) ◽

pp. 1047

Author(s):

Yeo Hon Yun ◽

Myeung Cheol Shin ◽

Kwan Hee Lee ◽

Sang Jin Shin

Keyword(s):

Case Report ◽

Cubitus Varus ◽

Rotatory Instability ◽

Posterolateral Rotatory Instability

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Elbow Posterolateral Rotatory Instability due to Cubitus Varus and Overuse

Case Reports in Orthopedics ◽

10.1155/2018/1491540 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Juan Martín Patiño ◽

Alejandro Rullan Corna ◽

Alejandro Michelini ◽

Ignacio Abdon ◽

Alejandro José Ramos Vertiz

Keyword(s):

Tennis Elbow ◽

Distal Humerus ◽

Cubitus Varus ◽

Rotatory Instability ◽

Posterolateral Rotatory Instability ◽

Humerus Fractures ◽

Distal Humerus Fractures

A malunion as a complication of distal humerus fractures has been frequently linked with aesthetic problems but less frequently with posterolateral rotatory instability. We report 2 cases of childhood posttraumatic cubitus varus with subsequent posterolateral rotatory instability and their treatment with a minimum of 2 years of follow-up. The etiology of the so-called posterolateral rotatory instability of the elbow is mostly traumatic, but iatrogenic causes have also been described such as the treatment of tennis elbow and less frequently and chronically due to overuse and overload because of distal humerus malunion.

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Corrective Osteotomy in cubitus varus deformity in children: A prospective study

Surgical Update: International Journal of Surgery and Orthopedics ◽

10.17511/ijoso.2021.i03.06 ◽

2021 ◽

Vol 7 (3) ◽

pp. 73-77

Author(s):

Dr. Abhinav Kotak ◽

◽

Dr. Suresh Rudani ◽

Keyword(s):

Late Complication ◽

Corrective Osteotomy ◽

Tertiary Care ◽

Varus Deformity ◽

Lateral Condyle ◽

Care Hospital ◽

Cubitus Varus ◽

Full Extension ◽

Dome Osteotomy ◽

Carrying Angle

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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Loss of correction in cubitus varus deformity after osteotomy

10.21203/rs.3.rs-26279/v1 ◽

2020 ◽

Author(s):

Chao You ◽

Yibiao Zhou ◽

Jingming Han

Keyword(s):

Cobb Angle ◽

Survival Curve ◽

Pediatric Population ◽

Deformity Correction ◽

Varus Deformity ◽

Cubitus Varus ◽

The Third ◽

Loss Of Correction ◽

Significant Difference

Abstract Purpose Cubitus varus deformity in the pediatric population is an infrequent but clinically important disease to orthopedic surgeons. Since these patient populations are different in many respects, we sought out to investigate the rates of loss of correction over time as well as the factors associated with loss of correction in pediatric patients undergoing osteotomy for treatment of cubitus varus deformity. Methods Between 2008-7 and 2017-7, we treated 30 cases of cubital varus had underwent the the osteotomy. We compared preoperative and postoperative clinical and imaging parameters (H-cobb angle,Baumman angle) for all patients. Postoperative evaluation was performed by telephone interview.Results In our study,there were 30 patients,included 17 males and 13 females.the mean age was 75 months old.In the first follow-up,Approximately 80 % of patients had a loss of correction of H-cobb，and 83% of patients at the second follow-up. The Baumann angle also had a loss of correction,about 57% was lost at the first follow-up,and 43% was lost at the second follow-up. The average interval between the first follow-up and the second follow-up was 24 days ，The H-cobb angle mean loss was 2.4°.There was a statistically significant difference between the H-cobb angle measured before surgery and the angle measured after surgery (p <0.05). There were significant differences between the two angles. There was no statistically significant difference between the H-cobb angle measured at the third postoperative period and the contralateral healthy elbow H-cobb angle. There was a statistically significant difference between the Baumann angle measured before surgery and the angle measured after surgery (p <0.05). The Baumann angle measured in the second and third postoperative periods was significantly different from that of the contralateral healthy elbow joint. According to the survival curve analysis, we can see that the median survival time of the H-cobb angle and the Baumann angle is 27 and 34 months. Conclusions The postoperative angle loss will last for a period of time, which mainly occurs during the first and second follow-up period . Therefore, it is important to pay attention to the follow-up of the patient for a period of time after the operation, and take measures to avoid rapid angle loss. Angle loss was significantly reduced after the third follow-up. Further study is needed on this subgroup of patients with cubitus varus given the differences in strategies needed to correct and maintain their deformity correction.

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Translation step-cut osteotomy for posttraumatic Cubitus Varus in adults: a retrospective study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03845-7 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Jung Ryul Kim ◽

Yoong Jae Moon ◽

Sung Il Wang

Keyword(s):

Functional Outcomes ◽

Three Dimensional ◽

Varus Deformity ◽

Delayed Union ◽

University Hospital ◽

Cubitus Varus ◽

Radiographic Measurements ◽

Significant Difference ◽

Flexion Extension

Abstract Background Cubitus varus is a complex three-dimensional deformity. Various osteotomies have been introduced to correct this complex deformity. The objective of the present study was to evaluate clinical and functional outcomes of adult cubitus varus deformity treated with translation step-cut osteotomy. Methods Seventeen consecutive patients with a mean age of 25 years (range, 19–50 years) who underwent translation step-cut osteotomy were enrolled in this study. Their average follow-up period was 28.2 months. Radiographic measurements preoperatively, 3-month postoperatively, and at the last follow-up were compared. Functional outcomes were assessed using Disabilities of the Arm, Shoulder and Hand (DASH), Mayo Elbow Performance Score (MEPS), and Oppenheim criteria. Results The mean humerus–elbow–wrist angle improved from 14.7° ± 6.4° (range, 6°–23°) varus preoperatively to 12.1° ± 6.6° (range, 5°–20°) valgus postoperatively (p < 0.001). The lateral prominence index improved 9.6% from its preoperative value, showing no significant difference from that of a normal elbow. Osseous union was radiographically demonstrated in 16 patients (except one out of 17 patients) within a mean of 12.7 weeks (range, 8–18 weeks). The motion arc of the elbow at the last follow-up was not significantly (p > 0.05) different from that at the initial presentation. Based on Oppenheim criteria, results were excellent for 7, good for 8, and poor for 2 patients. Mean final DASH value and MEPS were 2.5 ± 3.8 points (range, 0–15 points) and 97.0 ± 5.8 points (range, 85–100 points), respectively. With regard to complications, one case had delayed union and one case had transient radial nerve injury. Conclusion Translation step-cut osteotomy using Y plate is an efficient procedure to correct varus alignment and flexion-extension deformities so that they are within normal limits of adults with post-traumatic cubitus varus deformity. Trial registration Institutional Review Board of Jeonbuk National University Hospital (IRB No. 2020–01-020).

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