Cubitus varus in adults correction with lateral closing. Most case series on dome osteotomy using the posterior tricepssplitting. Laupattarakasem w, mahaisavariya b, kowsuwon w, saengnipanthkul s. Double dome osteotomy for the treatment of cubitus varus in children. A case report prakriti raj kandel, rajiv baral, niva chitrakar, gyaneshwar prasad singh, laxmi pathak journal of universal college of medical sciences 2016 vol. Preoperative planning software for corrective osteotomy in. Dome corrective osteotomy for cubitus varus deformity. Corrective dome osteotomy for cubitus varus and valgus in. The osteotomies were fixed with kwires and immobilised in a longarm cast. The purpose of this study was to report double dome osteotomy used to correct paediatric cubitus varus and to avoid lateral prominence after correction. Key words cubitus varus, elbow, osteotomy, dome, stepcut. Vivek dutt, in the department of orthopaedic surgery, christian medical college and hospital, vellore in partial fulfillment of the rules and regulations of the tamil nadu dr. Year 2004 view abstract orthopaedic trauma association 9400. On the right is the focal dome osteotomy made just distal to the tibial tuberosity and it is based on the cora as the hinge point.
Cubitus varus gunstock deformity, is the most common long term complication of childhood supracondylar fracture of the. Corrective osteotomy osteotomy is the only way to correct a cubitus varus deformity with a high probability of success. Clinical outcome of dome osteotomy in cubitus varus medcrave. Maquet dome osteotomy focal dome osteotomy on the left is the maquet dome osteotomy made proximal to tibial tuberosity. Several surgical techniques have been described for the correction of the varus deformity in cubitus varus, including. Cubitus varus deformity rationale of treatment and methods. This prospective study included 15 cases of cubitus varus deformity of elbow over a period of 18 months. Considering the advantages of dome osteotomy, we did a study and evaluated the results of dome osteotomy. Supracondylar osteotomies of posttraumatic distal humeral. Some authors reported that dome osteotomy and stepcut osteotomy, which avoid lateral condylar prominence, produced satisfactory results. Preoperative planning software for corrective osteotomy in cubitus varus and cubitus valgus. Medial open wedge osteotomy lateral closing wedge osteotomy also known as french osteotomy. The followup period varied between 22 and 36 months average, 27.
Cubitus varus, cubitus valgus, osteotomy, geometric modelling, constructive solid geometry, computer aided. The osteotomy was performed through posterior approach. Utilization of a 3dprinted model for preoperative planning and. The management of cubitus varus and valgus using the. Pdf corrective dome osteotomy for cubitus varus and. Clinical outcome of dome osteotomy in cubitus varus.
The objective evaluation was done by one of the authors by measuring the pre and postoperative lateral condylar prominence index. Impact of plate positioning on the lateral closing wedge. There are various types of corrective osteotomy and fixation methods of cubitus varus deformity. Surgical correction of cubitus varus chest journal. It creates an arcuate or dome shaped osteotomy with correction into valgus. Nonunion of lateral humeral condylar fracture in a child. K wire is the better fixation technique compared to plate fixation in dome osteotomy. Corrective dome osteotomy using the paratricipital. Original study the equal limbs lateral closing wedge osteotomy. A corrective dome osteotomy was performed in 19 adult patients for cubitus varus and valgus deformity. Several surgical procedures for cubitus varus correction, such as lateral closing wedge osteotomy, stepcut osteotomy and dome osteotomy, are performed frequently. Lateral condyle fractures following cubitus varus remain a common complication seen by pediatric orthopedists 5. Pdf twenty patients 11 males and nine females with cubitus varus deformity were treated with corrective dome osteotomy through the.
Double dome osteotomy created a proximal and distal cut, then varus deformity and sagittal alignment were corrected. Request pdf dome corrective osteotomy for cubitus varus deformity between 1994 and 1998, 15 patients had corrective dome shaped osteotomy of the humerus for posttraumatic cubitus varus deformity. Recent reports, however, show that these other consequences of cubitus varus may also be indications for operative reconstruction 412. Pdf clinical outcome of dome osteotomy in cubitus varus. Supracondylar osteotomy for the treatment of cubitus varus. Cubitus vams deformity is not a functional problem, but it may become so disfiguring that correction is indicated carlson et al. The average postoperative carrying angle in 16 patients with cubitus varus was 6. Dear sir, nonunion, and subsequently, cubitus valgus deformity are some of the unacceptable complications if the lateral humeral condyle lhc fracture has not been timely and appropriately treated. N2 cubitus varus is the most frequent complication following the treatment of supracondylar humeral fractures in children. Correction of cubitus varus by french or dome osteotomy. Corrective dome osteotomy for cubitus varus and valgus deformity young lae moon.
The dome osteotomy is another option, and is a different. Cubitus varus, lateral condyle, humerus, nonunion, resection osteotomy introduction cubitus varus is the most common complication following supracondylar fracture of the elbow in children. Double dome osteotomy created a proximal and distal cut, then varus. Cubitus varus, cubitus valgus, osteotomia, modelacao geometrica, geometria solida construtiva. Cubitus varus is a common complication of pe diatric supracondylar and lateral condyle frac. In fact, these type of deformities are very rare in adults 9,10. A surgical technique to avoid lateral condylar prominence dome osteotomy for posttraumatic cubitus varus. Request pdf dome corrective osteotomy for cubitus varus deformity between 1994 and 1998, 15 patients had corrective dome shaped osteotomy of the humerus for posttraumatic cubitus varus. Eighteen children with cubitus varus underwent double dome osteotomy. Double dome osteotomy for the treatment of cubitus varus.
Lateral closing wedge osteotomy with or without medialisation of the distal fragment for cubitus varus j orthop surg res 2010. Cubitus varus deformity is a common late complication of supracondylar fractures in the childhood. Treatment resulted in solid union, good range of motion and no avascular necrosis. There are several methods of fixation to hold corrective osteotomy as kwires. Background the purpose of this study was to compare the outcomes of two different techniques of supracondylar osteotomy, french osteotomy and dome osteotomy, for the correction of posttraumatic cubitus varus methods a comparative randomized study was undertaken of 25 patients average age 10 years with an established posttraumatic cubitus varus deformity mean time from injury to corrective. New technique for correction of cubitus varus deformity is a bonafide work done by dr. The authors used the dome supracondylar osteotomy, as described by tien et al, as the corrective procedure for cubitus varus in 12 consecutive children.
Dome osteotomy is a simple, safe, and technically better procedure for cubitus varus correction. In all cases, medial translation for decreasing lateral condylar prominence or transposition of the. The correction was satisfactory in all the cases, and there was no serious. Kanaujia rr, ikuta y, muneshige h, higaki t, shimogaki k. These are lateral closing wedge osteotomy, medial opening osteotomy, three dimensional osteotomy, step cut osteotomy, and dome shaped osteotomy. Correction of cubitus varus by supracondylar lateral. In 11 children, varus deformity of the elbow after supracondylar or transcondylar fractures was corrected with a dome osteotomy. The present retrospective study was done with 11 children having cubitus varus following supracondylar fractures to access the stability of modified domeosteotomy and its fixation with kwires in older children. Preoperative templating created from radiographs was used to determine the bone cuts. Preoperative planning software for corrective osteotomy in cubitus. When a corrective osteotomy requires 15 degrees or greater, a reverse dome osteotomy 8 performed below the level of the tibial tubercle has allowed a very large angular correction of up to 30 degrees without distorting the proximal tibial geometry for eventual total knee arthroplasty. Pdf dome osteotomy using the paratricipital tricepssparing. Supracondylar dome osteotomy for cubitus valgus deformity associated with a lateral condylar nonunion in children j bone joint surg am 2005.
Research article open access correction of cubitus varus. The chance of lcp is less and yields a nearnormal cosmetic outcome. There are various options for correction of distal humerus deformities. A surgical technique to avoid lateral condylar prominence. Dome osteotomy has been described extensively in literature to correct posttraumatic cubitus varus deformity in children. Corrective dome osteotomy for cubitus varus and valgus deformity. Coxa valga describes a deformity of the hip where there is an increased angle between the femoral when the angle is coxa vara. Corrective dome osteotomy for cubitus varus and valgus. Lateral closingwedge osteotomy for cubitus varus deformity was performed in 52 children. During 2006 to 2009, 24 children with cubitus varus deformity after supracondylar humerus fracture were treated with a dome osteotomy using the tricepssparing approach. T1 supracondylar osteotomy for the treatment of cubitus varus in children. Surgical correction of cubitus varus sciencedirect.
Lateral closing wedge osteotomy with or without medialisation of the distal fragment for cubitus varus myungsang moon, 1 sungsoo kim, seongtae kim, 1 sungrak lee, bongjin lee, jongmun jin, jeonglim moon2 1 department of orthopedic surgery, cheju halla general hospital, jeju, korea 2 department of rehabilitation medicine, st marys hospital, catholic university of korea, seoul, korea. Original article impact of plate positioning on the. It is a retrospective case analysis of 7 cases of cubitusvarus in young adult treated with lateral closing wedge osteotomy. We present our experience of correction of cubitus varus in young adult with lateral closing wedge osteotomy and fixation with screw, ss wire and supplemented with cross k wires.
Clinical and radiological outcome following kims step cut. Data for 18 patients who underwent double dome osteotomy for the treatment of cubitus varus the ulnohumeral angle was measured pre and postoperatively. Nonetheless, the optimal management of the nonunion lhc fracture when presenting late with valgus deformity, the timing of surgery, which internal fixation method to use, and which osteotomy. Lateral closingwedge supracondylar osteotomy, although a widely used corrective procedure, tends to produce lateral condylar prominence, thus jeopardizing the cosmetic outcome. Remodeling after lateral closingwedge osteotomy in. Eamsobhana and kaewpornsawan performed a double dome osteotomy to more fully address both the coronal and sagittal plane deformities in cubitus varus.
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