Valgus Osteotomy of the Proximal Humerus to Treat Humerus Varus in Children

Abstract

Valgus osteotomy of the proximal humerus using a plate-screw fixation method can correct the deformity and provide strong fixation in children. The postoperative improvement of shoulder motion and radiologic changes were satisfactory. However, we need to do second operation to remove the plate. Meanwhile, the patients would require a second operation to elongate the affected limb.

Diagnosis and treatment of focal fibrocartilaginous dysplasia of the distal ulna

“…It is difficult to find and resect the lesions of the proximal humerus in the early stage. Osteotomy is usually used to correct the deformity and improve function after the occurrence of humeral varus deformity [9][10][11][12]18].…”

Corrective Proximal Humerus Osteotomy with Blade Plate Osteosynthesis in Adolescents

“…Early historical surgical interventions included acromionectomy and proximal humerus osteotomy with spica casting; however, these procedures were associated with a number of complications including aesthetic deformity and brachial plexus palsy 2,14,15 . More recent surgical techniques, as described by Gill and Waters 2 and Miao et al 1 , use tension band fixation and plate and screw constructs, respectively, for osteotomy fixation. Our case series uses a closing wedge osteotomy with 90° cannulated blade plate construct to achieve fixation.…”

“…Common causes of proximal humeral varus in children include congenital, idiopathic, traumatic, hematologic and infectious etiologies [1][2][3][4] . Whereas the patient in case 1 sustained an acute proximal humerus fracture with subsequent malunion, the patient in case 2 was a baseball pitcher and likely sustained physeal arrest secondary to the repetitive trauma associated with high velocity overhead throwing.…”

“…Although the literature pertaining to surgical treatment of proximal humeral varus is sparse, Gill and Waters 2,7 previously described a closing wedge valgus osteotomy fixated with a tension band construct. Miao et al 1 described using plate and screw fixation in place of tension banding. In this case series, we describe a closing wedge valgus-producing derotational osteotomy using a 90° cannulated blade plate for fixation and provide preoperative and postoperative patient-reported outcome measures.…”

“…roximal humeral varus deformity in skeletally immature patients is a relatively rare phenomenon typically caused by malunion or growth arrest of the medial proximal humeral physis. Partial physeal arrest is most commonly the sequelae of previous trauma; however, it can also result from congenital, idiopathic, hematologic, and infectious etiologies [1][2][3][4] . Proximal humeral varus can be characterized radiographically by a humeral neck-shaft angle less than 140°or a greater tuberosity positioned above the superior margin of the humeral articular margin 5 .…”