Abstract
BackgroundCubitus varus is a complex three-dimensional deformity. Various osteotomies have been introduced to correct this complex deformity. The objective of the present study was to evaluate clinical and functional outcomes of adult cubitus varus deformity treated with translation step-cut osteotomy.MethodsSeventeen consecutive patients with a mean age of 25 years (range, 19–50 years) who underwent translation step-cut osteotomy were enrolled in this study. Their average follow-up period was 28.2 months. Radiographic measurements preoperatively, 3-month postoperatively, and at the last follow-up were compared. Functional outcomes were assessed using Disabilities of the Arm, Shoulder and Hand (DASH), Mayo Elbow Performance Score (MEPS), and Oppenheim criteria.ResultsThe mean humerus–elbow–wrist angle improved from 14.7° ± 6.4° (range, 6°–23°) varus preoperatively to 12.1° ± 6.6° (range, 5°–20°) valgus postoperatively (p < 0.001). The lateral prominence index improved 9.6% from its preoperative value, showing no significant difference from that of a normal elbow. Osseous union was radiographically demonstrated in 16 patients (except one out of 17 patients) within a mean of 12.7 weeks (range, 8–18 weeks). The motion arc of the elbow at the last follow-up was not significantly (p > 0.05) different from that at the initial presentation. Based on Oppenheim criteria, results were excellent for 7, good for 8, and poor for 2 patients. Mean final DASH value and MEPS were 2.5 ± 3.8 points (range, 0–15 points) and 97.0 ± 5.8 points (range, 85–100 points), respectively. With regard to complications, one case had delayed union and one case had transient radial nerve injury.ConclusionTranslation step-cut osteotomy using Y plate is an efficient procedure to correct varus alignment and flexion-extension deformities so that they are within normal limits of adults with post-traumatic cubitus varus deformity.Trial registrationInstitutional Review Board of Jeonbuk National University Hospital (IRB No. 2020–01-020).
Highlights
Cubitus varus is a complex three-dimensional deformity
Cubitus varus has been conventionally described as a cosmetic deformity with little functional disability, surgical treatment might be necessary when patients are unsatisfied with the appearance of their arms or have late sequelae such as chronic pain, ulnar nerve palsy [1, 2], posterolateral rotary instability [3], and snapping elbow [4]
We hypothesized that our step cut osteotomy would be an efficient procedure to correct varus alignment and flexion-extension deformities to be within normal limits
Summary
Cubitus varus is a complex three-dimensional deformity. Various osteotomies have been introduced to correct this complex deformity. Various osteotomies have been proposed to correct this complex deformity, including lateral closing wedge, medial opening wedge, dome-shaped, pentalateral, and three-dimensional osteotomies [5,6,7,8,9,10,11,12]. Most of these osteotomies have been performed in young or mixed age groups. We attempted to simultaneously correct varus and flexion–extension deformities, and lateral protrusion of distal fragments with translation step-cut osteotomy in adults. We hypothesized that our step cut osteotomy would be an efficient procedure to correct varus alignment and flexion-extension deformities to be within normal limits
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