Management of Cubitus Varus Deformity in Children by Closed Dome Osteotomy

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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Dome Osteotomy Results for Correction of Cubitus Varus Deformity

Turkiye Klinikleri Journal of Medical Sciences ◽

10.5336/medsci.2015-43719 ◽

2015 ◽

Vol 35 (3) ◽

pp. 157-165

Author(s):

Kürşad AYTEKİN ◽

Bora BOSTAN ◽

Orhan BALTA ◽

Recep KURNAZ ◽

Murat AŞCI ◽

...

Keyword(s):

Varus Deformity ◽

Cubitus Varus ◽

Dome Osteotomy

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Outcome of Corrective Dome Osteotomy for Cubitus Varus Deformity

Journal of Nobel Medical College ◽

10.3126/jonmc.v8i2.26760 ◽

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.

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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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An Innovative and Cost-Advantage CAD Solution for Cubitus Varus Surgical Planning in Children

Applied Sciences ◽

10.3390/app11094057 ◽

2021 ◽

Vol 11 (9) ◽

pp. 4057

Author(s):

Leonardo Frizziero ◽

Gian Maria Santi ◽

Christian Leon-Cardenas ◽

Giampiero Donnici ◽

Alfredo Liverani ◽

...

Keyword(s):

Computer Aided Design ◽

Low Cost ◽

Cost Effective ◽

Varus Deformity ◽

Patient Specific ◽

Cubitus Varus ◽

Surgical Guide ◽

Traditional Procedure ◽

Custom Made ◽

Patient Specific Instruments

The study of CAD (computer aided design) modeling, design and manufacturing techniques has undergone a rapid growth over the past decades. In medicine, this development mainly concerned the dental and maxillofacial sectors. Significant progress has also been made in orthopedics with pre-operative CAD simulations, printing of bone models and production of patient-specific instruments. However, the traditional procedure that formulates the surgical plan based exclusively on two-dimensional images and interventions performed without the aid of specific instruments for the patient and is currently the most used surgical technique. The production of custom-made tools for the patient, in fact, is often expensive and its use is limited to a few hospitals. The purpose of this study is to show an innovative and cost-effective procedure aimed at prototyping a custom-made surgical guide for address the cubitus varus deformity on a pediatric patient. The cutting guides were obtained through an additive manufacturing process that starts from the 3D digital model of the patient’s bone and allows to design specific models using Creo Parametric. The result is a tool that adheres perfectly to the patient’s bone and guides the surgeon during the osteotomy procedure. The low cost of the methodology described makes it worth noticing by any health institution.

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