scholarly journals Outcome of three dimensional osteotomy for cubitus varus deformity

2021 ◽  
Vol 7 (3) ◽  
pp. 444
Author(s):  
Krishna Priya Das ◽  
Nakul Kumar Datta ◽  
Mohammad Zahidulhak Khan ◽  
Jahidul Islam ◽  
Rumpa Mani Chowdhury
Keyword(s):  
Three Dimensional ◽  
Varus Deformity ◽  
Angular Deformity ◽  
Cubitus Varus ◽  
Satisfactory Outcome ◽  
Internal Rotation Angle ◽  
Clinical And Radiological Outcome ◽  
Safe Technique ◽  
Carrying Angle

<p><strong>Background:</strong> 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.</p><p><strong>Methods</strong>: 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.</p><p><strong>Results:</strong> 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.</p><p><strong>Conclusions:</strong> 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.</p>

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

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).

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

2019 ◽  
Vol 14 (1) ◽  
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.

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

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.

scholarly journals Ulrasonography guided Closed Reduction in the Treatment of Displaced Transphyseal Fracture of the Distal Humerus

2020 ◽  
Author(s):  
Hai Zhou ◽  
Ge Zhang ◽  
Ming Li ◽  
Xiangyang Qu ◽  
Yujiang Cao ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Elbow Flexion ◽  
Distal Humerus ◽  
Cubitus Varus ◽  
Radiographic Outcomes ◽  
Male Patients ◽  
The Mean ◽  
Carrying Angle ◽  
Low Incidence

Abstract Background: To evaluate the clinical and radiographic outcomes after ulrasonography guided Closed reduction in the treatment of displaced transphyseal fracture of the distal Humerus (TFDH).Methods: Twenty-seven patients with displaced TFDH successfully treated by the ulrasonography guided closed reduction during January 2012 to December 2016 were retrospective reviewed. After mean follow-up of 34.88 months, the clinical and radiographic outcomes of patients were evaluated. The cubitus varus of the affected elbow were also assessed at latest follow-up.Results: The successful rate of ultrasonography guided closed reduction in the treatment of displaced TFDH was 84% (27/32). The twenty-seven patients with successful reduction were included for the following analysis. There were 20 male patients and 7 female patients included the study and the mean age at treatment was 15.39±3.10 months, seventeen fractures occurred in right side elbow and ten in left side. At the last follow-up, there were significant decreases in the elbow flexion (3°, P=0.027) and range of motion (5°, P=0.003) between the injured and uninjured elbow, respectively. Whereas no difference in elbow extension was detected (P=0.110). Flynn’s criteria assessment showed that all the patients achieved excellent or good outcomes both in the functional and cosmetic categories. The clinical and radiographic carrying angle at the last follow-up were 11.67 ± 3.11° and 10.46 ± 3.88°, respectively. And the incidence of cubitus varus after treament was 7.4% at last follow-up.Conclusion: The ultrasonography guided closed reduction in the treatment of displaced TFDH is an effective procedure, the adequate fracture reduction can be acquired with the advantages of real-time, non-radioactive, and simple utilization. With the percutaneous pining fixation, satisfactory clinical and radiographic outcomes can be achieved with low incidence of postoperative cubitus varus.

scholarly journals Loss of correction in cubitus varus deformity after osteotomy

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.

scholarly journals Prospective study of cubitus varus deformity, its etiopathology, clinical study and treatment

2016 ◽  
Vol 5 (1) ◽  
pp. 201
Author(s):  
Ulhas Dudhekar
Keyword(s):  
Varus Deformity ◽  
Age Group ◽  
Cubitus Varus ◽  
Supracondylar Fractures ◽  
Normal Range ◽  
Non Union ◽  
Functional Problem ◽  
Technical Details ◽  
Carrying Angle ◽  
Supracondylar Osteotomy

Background: Loss of carrying angle at elbow (Cubitus varus) remains one of the commonest complications of supracondylar fractures. Despite the numerous ways are described of treating supracondylar fractures, cubitus varus remains a significant problem. It can only be prevented by achieving and maintaining accurate reduction. Cubitus varus deformity is not a functional problem, but it may become so disfiguring that correction is indicated.Methods: A total of 10 cases of cubitus varus deformity were treated with modified French osteotomy outcome was measured with by the method of Oppenheim WL, Clader et al.Results: In this study 10 cases treated with modified French osteotomy. In the present study 70% cases were female. All the patients were in the age group of 6-13 years. The average correction of carrying angle was 5.7 0 of valgus. All the patients were having nearly normal range of motion of the affected elbow. Only one patient suffered radial nerve injury. There was no infection or hypertrophic scar or non-union. The study showed result in the form of excellent - 70%, Good - 20% and poor - 10%.Conclusions: Modified French method proved safe and satisfactory as it has improved anatomy and cosmetic results. Loss of correction of cubitus varus deformity does not occur. A proper cases selection and proper planning of osteotomy, attention to the technical details is crucial to the success of supracondylar osteotomy of the humerus for correction of cubitus varus.

Three-dimensional analysis of cubitus varus deformity after supracondylar fractures of the humerus

2011 ◽  
Vol 20 (3) ◽  
pp. 440-448 ◽  
Author(s):  
Yukari Takeyasu ◽  
Tsuyoshi Murase ◽  
Junichi Miyake ◽  
Kunihiro Oka ◽  
Sayuri Arimitsu ◽  
...  
Keyword(s):  
Dimensional Analysis ◽  
Three Dimensional ◽  
Varus Deformity ◽  
Cubitus Varus ◽  
Supracondylar Fractures

scholarly journals Outcome of Corrective Dome Osteotomy for Cubitus Varus Deformity

2019 ◽  
Vol 8 (2) ◽  
pp. 42-46
Author(s):  
Ranjib Kumar Jha ◽  
Santosh Thapa ◽  
Dhiraj Singh
Keyword(s):  
Varus Deformity ◽  
Distal Humerus ◽  
Late Complications ◽  
Wedge Osteotomy ◽  
Cubitus Varus ◽  
Excellent Outcome ◽  
Dome Osteotomy ◽  
Versatile Technique ◽  
Carrying Angle ◽  
Operative Assessment

Background: The cubitus varus deformity is one of the most common late complications of fracture supracondylar area of humerus in children. Various corrective osteotomies are used of which lateral closed wedge osteotomy is commonly done which has its own disadvantages like lateral condylar prominence, difficulty in achieving correction and limitation of movement. Dome osteotomy is a versatile technique to achieve correction of deformity in all planes and to overcome these above complications. The aim of this study was to evaluate the results of dome osteotomy for correction of post-traumatic cubitus varus deformity of elbow in children. Materials and Methods: The study included 18 children between 6-13 years of age of both sex with malunited supracondylar fracture of distal humerus having cubitus varus deformity. After appropriate pre- operative assessment, dome osteotomy was done by posterior approach. In pre and post operative x-ray carrying angle and lateral condylar prominence Index (LCPI) were calculated. Patients were re-assessed at complete union and results were calculated. Results: In this study of 18 patients, 12 were males and 6 were females. The age ranged from 6-13 yrs with average of 8.4yrs. The average correction of carrying angle was from -22.4 degree to +10 degree. LCPI changed post operatively ranging from -8.6% to +3.25%, average -2.9%. There were no significant complications. Fifteen patients had excellent outcome and 3 had good outcome. Conclusion: The results in our study concluded that dome osteotomy for cubitus varus is safe and effective method and give cosmetically more acceptable elbow.

scholarly journals SUPRACONDYLAR FRACTURE OF HUMERUS;

2012 ◽  
Vol 19 (03) ◽  
pp. 308-311
Author(s):  
WASIM ANWAR ◽  
Mohammad SIRAJ ◽  
NOOR RAHMAN ◽  
Malik Javed Iqbal ◽  
Israr Ahmad ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Cubitus Varus ◽  
Supracondylar Fractures ◽  
Injured Side ◽  
Fractures In Children ◽  
The Mean ◽  
Carrying Angle ◽  
One Year

Objectives: To assess closed reduction by Baumann angle in supracondylar fractures humerus treated by closed reduction andpercutaneous pinning. Material and Methods: This prospective study of 50 patients who presented with displaced supracondylar fracture ofhumerus in children between ages 1-12 years were admitted to Orthopedic and Trauma unit of Hayatabad Medical Complex Peshawar overperiod from January 2008 to July 2009. Closed reduction and percutaneous pinning were performed under general anesthesia and postoperativereduction was assessed by Baumann angle. All patients were followed for one year. Results: Mean age of the patients was 7.02 years± 2.25 SD. Loss of Baumann angle in injured side was range from 2O to 8O. Loss of carrying angle in injured side was range from 3O to 9O. WhenBaumann angle and carrying angle of both sides were compared the mean Baumann angle loss and carrying angle loss were 5.360 ± 2.22 SDand 4.320 ± 1.52 SD respectively. Using Flynn’s criteria 36 (72%) patients out of 50 patients with carrying-angle loss considered to be excellentresults and 14(28%) good results. Neither of the patient developed cubitus varus deformit y after one year of follow-up. Conclusions: Baumannangle of the humerus is a simple and reliable measurement of closed reduction that can be used to predict final carrying angle in supracondylarhumeral fractures in children.

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