Step cut closing wedge osteotomy and lateral plating for cubitus varus in adults

Abstract

Background: Various osteotomies have been in use for correction of varus deformity at elbow in adults. The objective of the study was to determine the clinical, radiological and cosmetic outcome of closing wedge step cut osteotomy and lateral plating in adults with cubitus varus.Methods: This retrospective study was conducted among 15 cases of cubitus varus at an average age of 23.94 years (range, 18-31 years) and underwent closing wedge step cut osteotomy. Osteotomy was fixed with precontoured lateral locking plate. The carrying angle and range of motion of the elbow in preoperative period and final postoperative follow up was evaluated. Results: The average carrying angle improved from 20.8° (range, 12°-30°) varus to 8.66° (range, 5°-14°) valgus. Osseous union was radiographically demonstrated in all patients at an average of 13.33 weeks (range, 10-18 weeks). Lateral condylar prominence index improved from a mean of 6 (ranging from 2.5 to -8) to -12(ranging from -8 to -14). The preoperative (127.85°) and postoperative (124°) range of motion was almost similar. The average preoperative internal rotation was 14.66◦ (range, 0-25), which was corrected to 4.66◦ (range, 0–10) postoperatively. According to Oppenheim criteria, results were excellent in 6, and good in 9. The average final Mayo Elbow Performance Score was 93.33 points (range, 85–100 points). No patient had residual or recurrence of varus deformity, ulnar nerve palsy, elbow instability, implant failure or wound problems.Conclusions: Closing wedge step cut wedge osteotomy with lateral plating is an effective, reliable and technically less demanding corrective surgery in adults with minimum complications.