scholarly journals Supracondylar Osteotomies of Posttraumatic Distal Humeral Deformities in Young Adults - Technique and Results

2011 ◽  
Vol 5 (1) ◽  
pp. 389-394 ◽  
Author(s):  
Fokko Richard Buß ◽  
Arndt-Peter Schulz ◽  
Helmut Lill ◽  
Christine Voigt
Keyword(s):  
Young Adults ◽  
Late Complication ◽  
Varus Deformity ◽  
Functional Results ◽  
Distal Humerus ◽  
Valgus Deformity ◽  
Wedge Osteotomy ◽  
Lateral Epicondyle ◽  
Fractures In Children ◽  
Closed Wedge

Background: Cubitus varus deformity is the most common late complication after distal humeral fractures in children. Typical symptoms are increasing instability especially the posterolateral rotatory instability (POLRI), lateral elbow pain and cosmetic problems. Different ways of correction have been described but a gold standard has not yet been established. Methods: In this study the clinical outcome 6,5 months after supracondylar closed wedge osteotomy stabilized with locking plates in four young adults was investigated: three with a posttraumatic varus deformity and one with a posttraumatic valgus deformity of the distal humerus. Results: All patients showed good or excellent results in the Mayo Elbow Performance Score (MEPS) and the Disabilities of the Arm, Shoulder and Hand score (DASH). In one case, a revision because of a delayed union was necessary, in another case a preexisting pseudarthrosis of the radial epicondyle remained. Neither a residual instability of the elbow joint, nor any significant prominence of the lateral epicondyle was observed. Conclusion: The supracondylar closed wedge osteotomy stabilized by a locking plate is an effective procedure for the correction of posttraumatic distal humerus deformities in young adults with good final functional results.

The Rationale of Osteotomy around the Knee

2017 ◽  
Vol 30 (05) ◽  
pp. 386-392 ◽  
Author(s):  
Philipp Lobenhoffer
Keyword(s):  
Sagittal Plane ◽  
Weight Bearing ◽  
Cartilage Damage ◽  
Frontal Plane ◽  
Varus Deformity ◽  
Valgus Deformity ◽  
Wedge Osteotomy ◽  
Early Weight Bearing ◽  
Plate Fixator ◽  
Closed Wedge

AbstractFrontal plane varus or valgus deformity causes overload in the ipsilateral compartment and may induce and accelerate cartilage damage. Osteotomy around the knee should be considered in symptomatic constitutional and posttraumatic metaphyseal deformities of more than 3-degree deviation. Age, grade of osteoarthritis, obesity, and nicotine consumption are no exclusion criteria for osteotomy. For correction of varus deformity, biplanar open wedge osteotomy of the tibia with fixation by a plate fixator has proven to be a safe and stable construct allowing for early weight-bearing. Valgus deformities of the tibia can be treated by biplanar closed wedge osteotomy of the proximal tibia. For femur deformities closed wedge biplanar osteotomy and fixation with a specific plate fixator is an attractive solution reducing implant-related morbidity. Osteotomy around the knee may also be used to protect cartilage reconstruction and meniscus transplantation. Corrections in the sagittal plane may improve the anteroposterior stability of the knee significantly and can be combined with frontal plane corrections.

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 Cubitus varus deformity in young adults, Correction by rigidly fixed lateral closing wedge osteotomy

2019 ◽  
Vol 5 (2) ◽  
pp. 141-144
Author(s):  
Younis Kamal ◽  
◽  
Snobar Gul ◽  
Javaid Ahmed ◽  
Murtaza Fazal Ali ◽  
...  
Keyword(s):  
Young Adults ◽  
Varus Deformity ◽  
Wedge Osteotomy ◽  
Cubitus Varus ◽  
Closing Wedge Osteotomy ◽  
Closing Wedge

scholarly journals Lateral closed wedge osteotomy for cubitus varus deformity

2008 ◽  
Vol 42 (4) ◽  
pp. 466 ◽  
Author(s):  
AmitK Srivastava ◽  
DC Srivastava ◽  
SC Gaur
Keyword(s):  
Varus Deformity ◽  
Wedge Osteotomy ◽  
Cubitus Varus ◽  
Closed Wedge

scholarly journals Unilateral external fixation of the tibial shaft malunion

2020 ◽  
Vol 148 (1-2) ◽  
pp. 37-40
Author(s):  
Sasa Milenkovic ◽  
Milan Mitkovic ◽  
Milorad Mitkovic
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Varus Deformity ◽  
Functional Results ◽  
Clinical Results ◽  
Valgus Deformity ◽  
Healing Time ◽  
Fixation Method ◽  
Tibial Shaft ◽  
Complications Rate

Introduction/Objective. Fracture malunion is still a major problem in orthopaedic practice. The external fixation of tibial fracture malunion has become popular in recent years. The objective of this work was to evaluate clinical results in tibial shaft malunion treatment based on unilateral external fixation method. Methods. The patients with tibial shaft malunion have surgically been treated by unilateral Mitkovic external fixation system. Malunion deformities were corrected by ?one stage? technique, using Mitkovic-CD type external fixator, or gradually, using Mitkovic-V type external fixator. This retrospective study included 15 patients with tibial shaft angular malunion. The main type of malunion was valgus deformity, in 10 patients, and varus deformity, in five patients. Results. The mean healing time was 89.66 days (range 50?125). There were no complications in the present study. The follow-up time after surgery was three years. Final functional results were excellent in 13 cases and good in two cases. Conclusion. This unilateral external fixator system was successfully used in the treatment of tibial shaft malunion, with good results and low complications rate.

scholarly journals Comparison of Sagittal and Frontal Plane Alignment after Open- and Closed-Wedge Osteotomy: A Matched-Pair Analysis

2008 ◽  
Vol 36 (5) ◽  
pp. 1085-1093 ◽  
Author(s):  
TK Schaefer ◽  
M Majewski ◽  
MT Hirschmann ◽  
NF Friederich
Keyword(s):  
Frontal Plane ◽  
Varus Deformity ◽  
Tibial Slope ◽  
Matched Pair ◽  
Wedge Osteotomy ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Matched Pair Analysis ◽  
Closed Wedge ◽  
Open Wedge Hto

High tibial osteotomy (HTO) is a procedure for treating medial compartment osteoarthritis (OA) of the varus deformed knee. Frontal and sagittal alignment after closed- and open-wedge HTO were compared radiologically in a matched-pair study. The mean intra-operative frontal plane correction (FT axis) was +7.5° for closed-wedge HTO and +8° for open-wedge HTO; it increased by +0.5° in closed-wedge HTO and decreased by −0.5° in open-wedge HTO at last follow-up. Post-operatively, tibial slope had decreased by −0.5° in closed-wedge HTO and increased significantly by +3° in open-wedge HTO. Both techniques effectively and safely corrected varus deformity. A high degree of stability of the frontal plane correction was noted, however a significant change in the tibial slope after open-wedge HTO was observed post-operatively. As no loss of correction was shown, it may be related to the surgical technique rather than to the implant used.

scholarly journals Closed-Wedge Osteotomy of the Distal Humerus for Treating Osteochondritis Dissecans of the Capitellum in Young Patients

2019 ◽  
Vol 7 (10) ◽  
pp. 232596711987624 ◽  
Author(s):  
Masato Ueki ◽  
Koji Moriya ◽  
Takae Yoshizu ◽  
Naoto Tsubokawa ◽  
Hisao Kouda ◽  
...  
Keyword(s):  
Young Patients ◽  
Distal Humerus ◽  
Wedge Osteotomy ◽  
Advanced Stage ◽  
Fishtail Deformity ◽  
Closed Wedge ◽  
The Mean ◽  
Poor Outcomes ◽  
Clinical And Radiological Results

Background: Even in patients with an open capitellar physis, nonsurgical treatment for advanced-stage osteochondritis dissecans (OCD) of the capitellum often yields poor outcomes. However, surgical methods for such patients are controversial. At our institution, we have consistently performed closed-wedge osteotomy of the distal humerus to treat advanced-stage OCD of the capitellum, regardless of the OCD grade or condition of the capitellar physis. Purpose: To clarify the clinical and radiological results and determine the influence of the capitellar physis on closed-wedge osteotomy for advanced-stage OCD of the capitellum in young patients. Study Design: Case series; Level of evidence, 4. Methods: A total of 32 patients with OCD of the humeral capitellum were treated surgically with closed-wedge osteotomy. Of these, 17 patients with more than 2-year follow-up were available for an evaluation. The mean patient age was 11.8 years (range, 11-12 years), and the mean follow-up period was 70.1 months (range, 25-184 months). The clinical assessment included range of motion, elbow pain, and the Japanese Orthopaedic Association (JOA) and Timmerman-Andrews scores. The radiological assessment at the final examination included cross-bridging of the physis, size and fishtail deformity of the distal part of the humerus, size of the radial head, healing of the OCD lesion, and osteoarthritis. Results: The mean range of motion and JOA and Timmerman-Andrews scores improved significantly after surgery; 13 patients were completely pain free. In 11 patients with an open capitellar physis, metaphyseal-epiphyseal, cross-bridging was observed in 1 patient. A fishtail deformity of the distal part of the humerus was not observed. Healing of the OCD lesion was defined as excellent in 9 patients, good in 3, fair in 3, and poor in 2. In 3 of the 5 patients in whom healing was described as fair or poor, there was a lesion of the lateral widespread type with osteoarthritis before surgery. Moderate osteoarthritic changes were evident in 2 patients. Conclusion: Closed-wedge osteotomy for the treatment of advanced-stage OCD of the capitellum in young patients can provide satisfactory clinical and radiological results. However, fair and poor outcomes were found in lateral widespread–type cases with osteoarthritis before surgery. We believe that patients in whom osteoarthritic changes have not yet appeared are eligible for closed-wedge osteotomy.

Open or Closed Pinning for Distal Humerus Fractures in Children?

Swiss Surgery ◽  
2003 ◽  
Vol 9 (2) ◽  
pp. 76-81 ◽  
Author(s):  
de Buys Roessingh ◽  
Reinberg
Keyword(s):  
Distal Humerus ◽  
Neurological Involvement ◽  
Cubitus Varus ◽  
Cubitus Valgus ◽  
Fractures In Children ◽  
Motor Deficiency ◽  
Humerus Fractures ◽  
Distal Humerus Fractures ◽  
With Screws ◽  
Length Of Hospitalization

Introduction: In children, the choice between percutaneous pinning (PP) and open pinning fixation (OPF) for the surgical treatment of fractures of the distal humerus remains controversial, especially the PP method for internal humeral condylar (IHC) fractures. Patients and methods: Eighty fractures of the distal humerus in children were treated surgically in our hospital over a ten year period. 47% (n = 38) were supracondylar (SC), 20% (n = 16) comminuted (COM), 18% (n = 14) internal humeral condylar (IHC), and 15% (n = 12) lateral humeral condylar (LHC). We used PP, OPF and three times osteosynthesis with screws. Results: In comparison to OPF, PP reduced the length of hospitalization in SC fractures (2.8 versus 6.1 days) and IHC fractures (2.4 versus five days). It reduced the risk of extension deficiency (11.1% versus 15%) and of cubitus valgus (0% versus 20%) in SC fractures, and of cubitus varus in IHC fractures (0% versus 11.1%). However it induced a higher rate of cubitus valgus (11.1% versus 20%) in IHC fractures, one persistent neurological motor deficiency (radial nerve) and four cases of transitional neurological involvement (ulnar nerve). Conclusions: PP is a good surgical method for SC and for also for IHC fractures, if performed by experienced surgeons so as to avoid neurological damage.

Sign in / Sign up

Export Citation Format

Share Document