A prospective study of malunited supracondylar fracture of humerus in children treated with lateral closed wedge (LCW) osteotomy

Abstract

Background: Cubitus varus is the most common late complication of displaced supracondylar fractures of the humerus in children and may lead to long-term problems such as increased chances of lateral humeral condyle fractures, posterolateral instability of the elbow, and tardy ulnar nerve palsy Supracondylar humeral fractures are most common elbow fractures in children. The most common complication among all is malunion leading to cubitus varus deformity.Lateral closing wedge osteotomy is the easiest, the safest, and inherently the most stable osteotomy to correct the varus deformity with minimal correction of hyperextension. Aim: To examine the malunited supracondylar fracture of humerus in children treated with lateral closed wedge (LCW) osteotomy with cubitus varus. Material and Methods: A total of 25 children of malunited supracondylar fracture of humerus were treated by lateral closed wedge osteotomy fixed by two screws and figure of eight tension band wire.The fixation was supplemented with one lateral K-wire. Post-operatively, according to Oppenheim’s criteria patient were evaluated and parents and patient’s satisfaction with final appearance and function of the limb was taken into consideration. Results: According to the Oppenheim et al. criteria, is similar to our study, excellent outcome was noted in 18(72%) cases, good outcome in 5(20%) cases and poor outcome in 2(8%) cases. 18(92%) patients/parentswere satisfied with the final outcome. Conclusion: Lateral closing wedge osteotomy with a lateral K-wire is a sound, cost-effective, technically less demanding modality of treatment for varus deformity with less complications.