Translation step-cut osteotomy for posttraumatic Cubitus Varus in adults: a retrospective study

Abstract

Background Cubitus 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. Methods Seventeen 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. Results The 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. Conclusion Translation 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 registration Institutional Review Board of Jeonbuk National University Hospital (IRB No. 2020–01-020).

Comparison of Functional and Cosmetic Outcomes According to Fracture Level in Gartland Type III Pediatric Supracondylar Humerus Fractures

“…Although the cause of varus deformity remains uncertain, many authors believe that angular and rotational deformities are causes of varus deforimity. 18) de Gheldere and Bellan 19) have reported that laterally torn periosteum is associated with posteromedially displaced fractures, whereas medial periosteal rupture is associated with posterolateral displaced fractures, providing a higher Baumann value inducing cubitus varus deformity in the posteromedially displaced type. Small distal bone fragments might cause varus deformity by making accurate closed reduction difficult.…”

Lateral Collateral Ligament Reconstruction Using the Triceps Brachii Fascia for Posterolateral Rotatory Instability in Cubitus Varus: A Report of Two Cases

“…In children, the most common reason for surgery for cubitus varus is cosmetic deformity [2]. In adults, surgery has been considered when symptomatic conditions such as PLRI or ulnar nerve symptoms become apparent [1,[3][4][5] or when there is a cosmetic problem [6].…”

Neural wedge osteotomy method of correction for cubitus varus deformity in children

“…[5] The currently used osteotomies include lateral closed wedge osteotomy, [6] medial open wedge osteotomy, step-cut osteotomy, and dome-shaped osteotomy. [7] At present, lateral closed wedge osteotomy is the simplest and most commonly used osteotomy method in clinical practice. However, this method leads to an inconsistent diameter of the proximal and distal ends of the osteotomy and results in obvious deformity of the distal humerus, which is manifested by the appearance of the steps of the distal humerus on imaging.…”