scholarly journals Case Report: Locking Plate for Cubitus Varus Correction in a 7-Year-Old Girl With Osteogenesis Imperfecta

2022 ◽  
Vol 9 ◽  
Author(s):  
Pan Hong ◽  
Ruikang Liu ◽  
Saroj Rai ◽  
Jin Li
Keyword(s):  
Osteogenesis Imperfecta ◽  
Locking Plate ◽  
Varus Deformity ◽  
Supracondylar Fracture ◽  
Pharmacological Intervention ◽  
Corrective Surgery ◽  
Cubitus Varus ◽  
Elbow Fractures ◽  
Challenging Situation

Background: Cubitus varus deformity is a common complication of untreated elbow fractures in children. However, cubitus varus in osteogenesis imperfecta (OI) children is a rare but challenging situation. To the author's knowledge, this is the first study discussing the correction of cubitus varus deformity in patient with OI.Case Presentation: Here we report a case of a 7-year-old OI girl with cubitus varus deformity due to a supracondylar fracture of humerus 3 year ago. The patient's parent gave a history of supracondylar fracture of left humerus in 2015. Without medical intervention, the patient was admitted into our institution for corrective surgery with the diagnosis of osteogenesis imperfecta and cubitus varus deformity in the left arm.Result: Medications including calcium, vitamin D and bisphosphonates were administered before the corrective surgery of cubitus varus, and a single locking plate was used to fixate the osteotomy. After the surgery, the appearance and range of motion (ROM) of the left arm was almost normal. Combined with gradual rehabilitation, the ROM of the left arm was normal without pain during daily use within the 1-year follow up. The hardware was removed as the nailing of the forearm fractures was performed at the same time. In the latest follow-up in September 2021, the appearance and ROM of the left arm was normal.Conclusion: Cubitus varus is a common deformity in children with elbow injuries, but it presents a challenging situation in compound fractures in OI patients. Locking plate combined with meticulous pharmacological intervention provides a good option for corrective surgery of cubitus varus in patients with OI.

scholarly journals Locking plate for cubitus varus correction in osteogenesis imperfecta: a case report of 7 year-old girl

2020 ◽  
Author(s):  
Pan Hong ◽  
Ruikang Liu ◽  
Saroj Rai ◽  
Ruijing Xu ◽  
Jin Li
Keyword(s):  
Osteogenesis Imperfecta ◽  
Locking Plate ◽  
Varus Deformity ◽  
Supracondylar Fracture ◽  
Pharmacological Intervention ◽  
Corrective Surgery ◽  
Cubitus Varus ◽  
Supracondylar Fractures ◽  
Fractures In Children ◽  
Challenging Situation

Abstract Background Cubitus varus deformity is a common complication of supracondylar fractures in children. However, cubitus varus in osteogenesis imperfect (OI) children is a rare but challenging situation. To the author’s knowledge, it is the first study discussing the correction of cubitus varus deformity in OI patient. Here we report a case of an 7-year-old OI girl who presented with varus deformities of the bilateral lower extremities and cubitus varus deformity of the left elbow due to a supracondylar fracture of humerus 3 year ago. The patient’s parent gave a history of supracondylar fracture of left humerus 3 years ago. Without medical intervention, the patient was admitted into our institution for corrective surgery with the diagnosis of osteogenesis imperfecta and cubitus varus deformity in the left arm. Result Medications including calcium, vitamin D and bisphosphonates were administered before the corrective surgery of cubitus varus, and a single locking plate was used to after the osteotomy. Right after the surgery, the appearance and ROM of the left arm was almost normal. Combined with gradual rehabilitation, the ROM of the left arm was normal without pain during daily use. The hardware was removed as the nailing of the forearm fractures was performed at the same time. Conclusion Cubitus varus is a common deformity in children resulting from elbow injuries, but it presents a challenging situation in OI patients. Locking plate combined with meticulous pharmacological intervention provides a good option for corrective surgery of cubitus varus in OI.

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 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).

Supracondylar fracture of the humerus: malrotation versus cubitus varus deformity

Injury ◽  
1993 ◽  
Vol 24 (6) ◽  
pp. 416-418 ◽  
Author(s):  
B. Mahaisavariya ◽  
W. Laupattarakasem
Keyword(s):  
Varus Deformity ◽  
Supracondylar Fracture ◽  
Cubitus Varus

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 Use of 4.5 Non-locking Plate As an Alternative Device in Open Wedge High Tibial Osteotomy for Treating Varus Deformity

2020 ◽  
Vol 7 (2) ◽  
pp. 55-60
Author(s):  
Mahmood Jabalameli ◽  
◽  
Sepehr Khosravi ◽  
Delaram Delbari ◽  
Abolfazl Bagheri Fard ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Locking Plate ◽  
Varus Deformity ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Varus Knee ◽  
Knee Deformity ◽  
Wedge High Tibial Osteotomy ◽  
Buttress Plate

Background: High Tibial Osteotomy (HTO) is an approved surgical technique for varus knee deformity. For open wedge HTO multiple fixation methods and devices have been used. Advantages and disadvantages of these methods and devices are reported in various studies. Few studies have been conducted on use and final outcome of correction of varus knee deformity by implementation of non locking plates and benefits of this method is not fully evaluated. Objectives: To assess clinical and radiographic features of non-locking 4.5 millimeter L-buttress plate and T-buttress plate, which is used in open wedge High Tibial Osteotomy (HTO), and to find out whether this device is efficient enough or not. Methods: This cross-sectional study was conducted on 39 patients with tibial deformity recruited from a referral orthopedic hospital in Iran. Patients’ information, including their baseline characteristics, Range of Motion (ROM) of the knee, comorbidities, time of weight-bearing, union time in x-ray, graft type, and time of follow-up were reported at two stages: before and after the operation. Radiographic images were taken from their legs in both stages. Although different surgeons operated on the cases, they all used the same method. After the surgery, they were checked up in 2, 6, 12, and 24 weeks and a second alignment view was taken from the patients. Results: Thirty-nine patients underwent surgery for the correction of genu varus deformity and the follow-up time was between 6-48 months. There was no case of non-union and the ROM was perfectly restored in all the patients. Conclusion: Although the rate of the success in the use of the locking plate in HTO is higher, the use of a 4.5-mm non-locking plate seems to have decent results, too; therefore, it could be used as an alternative yet functional fixation tool in HTO.

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.

scholarly journals A clinical study of surgical management of paediatric humeral supracondylar fracture

2019 ◽  
Vol 5 (6) ◽  
pp. 1088
Author(s):  
Ajay Kumar ◽  
Karthik Padmanabhan
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Open Fracture ◽  
Supracondylar Fracture ◽  
Cubitus Varus ◽  
Inexpensive Method ◽  
Follow Up Study ◽  
Elbow Injuries ◽  
K Wires

<p class="abstract"><strong>Background:</strong> Injury to the supracondylar region of the humerus and complete displacement of the fragments occurs in many of the cases when children usually fall while playing. This is most common fracture seen in children, makes up to 60% of all elbow injuries. Early intervention results in excellent reduction and avoids complications. Concomitant vascular and nerve damages may occur. Open reduction and internal fixation is a helpful option for the treatment of supracondylar facture of humerus in children.</p><p class="abstract"><strong>Methods:</strong> Forty children who presented with displaced supracondylar fracture of the humerus were treated with open reduction and internal fixation with Kirschner (K) wires after thorough pre-operative investigation during the course of the study. Children below the age of 13 were selected irrespective of the sex.<strong></strong></p><p class="abstract"><strong>Results:</strong> Good results were obtained in 60% of the patients, fair in 30% and poor in 10%. The poor results were due to the open fracture and in two cases the patient presented very late to the hospital. Complications such as nerve injuries, vascular injuries, infections were noticed in the study. Four patients had cubitus varus and twelve patients had flexion loss on follow-up study.</p><p class="abstract"><strong>Conclusions:</strong> Open reduction and internal fixation with K wire is an easy, simple, inexpensive method, which has good outcome.</p>

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