Abstract
Purpose
To evaluate the effectiveness, cosmetic and functional improvement of a supracondylar lateral closing wedge osteotomy of the humerus as a treatment for cubitus varus deformity in children.
Materials and Methods
Forty-eight children with cubitus varus underwent a lateral closing wedge osteotomy, and were followed up for at least 1 year.
Results
There were no complications such as a loss of correction, infection, or neurapraxia. The immediate postoperative lateral condylar prominence and secondary lazy S deformity was in proportion to the preoperative severity of the cubitus varus. However, it was lower at the last follow-up, and was related to the extent of preoperative cubitus varus, length of follow-up and age.
Figures and Tables
Fig. 1
(A) Lateral closing wedge osteotomy was performed. (B) Lazy 'S' deformity was observed on the radiograph of two months after the operation.
![jkoa-43-17-g001](/upload/SynapseData/ArticleImage/0043jkoa/jkoa-43-17-g001.jpg)
Fig. 2
(A) Humero-ulnar angle was measured on the anteroposterior radiograph of the elbow. (B) Shaft-condylar angle was measured on the lateral radiograph of the elbow.
![jkoa-43-17-g002](/upload/SynapseData/ArticleImage/0043jkoa/jkoa-43-17-g002.jpg)
Fig. 3
(A) The angle of cubitus varus deformity was measured intraoperatively with C-arm fluoroscopy. (B) The operation was performed through a lateral approach. (C) We used two preset Kirschner's wires. (D) Osteotomized site was fixed with Steinmann pins. (E) Cubitus varus was corrected after surgery.
![jkoa-43-17-g003](/upload/SynapseData/ArticleImage/0043jkoa/jkoa-43-17-g003.jpg)
Fig. 4
(A) Lateral prominence index (LPI) is BC/AB. (B) Lateral prominence amount (LPA) is BC/AC × 100 (%).
![jkoa-43-17-g004](/upload/SynapseData/ArticleImage/0043jkoa/jkoa-43-17-g004.jpg)
Fig. 5
(A) A six-year-old boy had the varus humeroulnar angle of 33° on the preoperative radiograph. (B) On the immediate postoperative radiograph, LPI was 3.23 and LPA was 45.3 percent. (C) On the radiograph after a 4-year-follow-up, the LPI was 1.01, and the LPA was zero percent.
![jkoa-43-17-g005](/upload/SynapseData/ArticleImage/0043jkoa/jkoa-43-17-g005.jpg)
Fig. 7
The change in the amount of lateral prominence diminished with increasing age when the operation had been performed.
![jkoa-43-17-g007](/upload/SynapseData/ArticleImage/0043jkoa/jkoa-43-17-g007.jpg)
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