Journal List > J Korean Orthop Assoc > v.27(7) > 1114418

Cho, Song, Lee, Koo, Park, Jung, and Hwang: Supracondylar Osteotomy of Humerus for Cubitus Varus and Valgus

Abstract

The cubitus varus and valgus deformities are the common late complications caused by malunion or nonunion of the supracondylar or lateral condylar fractures of the distal humerus. These angular deformities rarely limit elbow function, and the correction is frequently requested due to cosmetic problem or tardy ulnar nerve palsy in severe cases. The authors evaluated the results from operative treatment of 30 cases of cubitus valgus and cubitus varus from March 1985 to June 1991. The results were as follows; 1. The age was distributed from 8 years to 45 years with most patients (11 cases) being in the 16-20 years. 2. There were 17 cubitus varus and 13 cubitus valgus. The most common cause of cubitus varus was the malunion of supracondylar fracture of humerus. The most common cause of cubitus valgus was the complication of lateral condylar fracture of the humerus. 3. In 30 cases, closing wedge osteotomies were performed in 23 cases. Varus angulation-lateral displacement osteotomies were performed in 6 cases of cubitus valgus developed after Milch type II fracture of lateral condyle of the humerus. The dome osteotomy was performed in 1 case of cubitus varus. 21 cases were fixed with k-wires, Steinmann pins, Plate and screws, and 9 cases were fixed with Ilizarov Fixators. 4. The average preoperative varus deformity was 20 degree (Humeral-Elbow-wrist angle) and the mean postoperative valgus carrying angle was 9 degree(Humeral-Elbow-wrist angle). The average preoperative valgus deformity was 31 degree and the mean postoperative valgus angle was 7 degree. In 30 cases, 15 cases were excellent results, ll cases were good results, and 4 cases were unsatisfactory results. 5. The complications were developed in 4 cases of the 30 cases. 1 case was nonunion in the group of steinmann pin fixator, 1 case was delayed union in the group of plate and screw, and 2 cases were temporary radial nerve palsy in group of Ilizarov fixation. Nonunion was treated with plate fixation and bone graft. 6. For patients over 15 years old, rigid fixation using plate or external fixator was needed to prevent the postoperative nonunion and for early motion of elbow joint. The Ilizarov method was useful for the ability of postoperative recorrection of carrying angle, easy translation-rotation of distal fragment with good fixation.

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