Clinical Outcome of Dome Osteotomy in Cubitus Varus

Abstract

Introduction: Cubitus varus (Gunstock deformity), is the most common long term complication of childhood supracondylar fracture of the humerus. For correction of cubitus varus deformity many types of osteotomies and fixations methods have been described. The most commonly used is the Lateral closing wedge osteotomy, which provides good results but results in two fragments of unequal width for bony union and the lateral condyle becomes prominent leading to Lateral condyle prominence, an another cosmetic deformity. To overcome this problem, Dome osteotomy was done. Material and Methods: This prospective study included 15 cases of cubitus varus deformity of elbow over a period of 18 months. Mean age of the cases was 9.07±3.07 years. Dome osteotomy with paratriceps approach was used. Pre and post -operative carrying angle of elbow, range of motion and lateral prominence indices were compared. Results: The mean follow-up period was 13.33±1.84 months. Mean time between injury and surgery was 16.53±4.10 months. There was significant improvement in carrying angle and lateral condylar prominence indices. Two of the cases developed transient ulnar nerve neuropraxia and one patient had superficial skin infection. Conclusion: Dome osteotomy is relatively technically demanding technique for correction of cubitus varus deformity but with better functional outcome without associated with lateral condyle prominence.