Corrective osteotomies for posttraumatic elbow deformities

Abstract

Correcion of elbow joint deformities that usually develop secondary to direct or indirect trauma of the arm or elbow with subsequent inadequate healing and consecutive axial/rotational malalignment and may be associated with cosmetic or functional deficits of the arm. Relevant malalignment of the arm axis with corresponding cosmetic or functional deficits for the patient. Pre-existing degenerative and chronic inflammatory changes. Generally, two-dimensional supracondylar open or closed wedge osteotomies are used. In the presence of athree-dimensional deformity (with rotational component), an additional derotational correction is necessary. Extra-articular deformities following extension fractures should be treated preferably with an open wedge osteotomy, extra-articular deformities of flexion fractures with aclosed wedge osteotomy. Valgus/varus deformities may also require aclosed/open wedge osteotomy primarily through adorsal or alternatively radial approach. The arm should be immobilized with abrachial cast splint for 2-3weeks, with passive exercises of the elbow starting on postoperative day7. In general, the results for athree-dimensional osteotomy of the distal humerus are expected to be good to very good. Only in rare cases (2.5%) is amostly transient irritation of the ulnar nerve observed.