Corrective Osteotomy in cubitus varus deformity in children: A prospective study

Abstract

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.