DOUBLE VOLUME INTERNAL FIXATION FOR CORRECTION OF ADULT POST-TRAUMATIC CUBITUS VARUS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DEFORMITYXIAO Jin , WU Wen , ZHAO Xiaoliang , WEI Jirong , GUO Xiaoze , YIN Qingshui , ZHANG Ying.

Hospital of Orthopedics, General Hospital of Guangzhou Military Command of Chinese PLA, Guangzhou Guangdong, 510010, P.R.China.;

Corresponding author：

Keywords：

Cubitus varus deformity; Reconstruction plate; Adult; Double columns internal fixation; Supracondylar fracture

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Objective Supracondylar closing wedge osteotomy is a standard operation for the management of post-traumatic cubitus varus deformity. There are many fixation methods for the broken ends of bone. However, most of these fixation methods are fraught with various complications. To evaluate the methods and functional results of double volume internal fixation for correction of adult post-traumatic cubitus varus deformity. Methods The cl inical data were retrospectively reviewed, from 22 cases of adults post-traumatic cubitus varus deformity between June 2007 and December 2010.There were 16 males and 6 females, aged 18-29 years (mean, 21 years) and they all had a history of supracondylar fracture. The deformities of cubitus varus appeared at 6 months (range, 3 months to 1 year) after fracture, and the operations were carried out at 4-17 years (mean, 8 years) after deformity occurrence. The valgus angle were 16-25° (mean, 20.6°) and the Flynn functional scores were all poor before operation. Supracondylar closing wedge osteotomies were performed. Two reconstruction plates were moulded and placed to the media and lateral volumes of the humerus to fix the broken ends of the osteotomy surfaces. External fixation was not needed and early rehabil itation was performed postoperatively in all cases. Results Incisions healed by first intention. All cases were followed up 6 to 24 months (mean, 13 months). At last follow-up, the valgus angle was 0-10° (mean, 7.5°). All cases got bone union at 8-13 weeks (mean, 10 weeks) after operation. No related complications occurred, such as infection, nervous or vein injury, and loosening or breakage of internal fixator; and no cubitus varus recurred. The Flynn scores were excellent in 17 cases, good in 3 cases, and fair in 2 cases; the excellent and good rate was 91%. Conclusion The operation of supracondylar osteotomy with double plates internal fixation for the correction of adult post-traumatic cubitus varus deformity can rigidly stabil ize distal humerus, which is helpful to functional training just after operation and satisfactory restoration of the elbow function.

Citation： DEFORMITYXIAO Jin,WU Wen,ZHAO Xiaoliang,WEI Jirong,GUO Xiaoze,YIN Qingshui,ZHANG Ying.. DOUBLE VOLUME INTERNAL FIXATION FOR CORRECTION OF ADULT POST-TRAUMATIC CUBITUS VARUS. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(4): 425-428. doi: Copy

1.	Omid R, Choi PD, Skaggs DL. Supracondylar humeral fractures in children. J Bone Joint Surg (Am), 2008, 90(5): 1121-1132.
2.	Koh KH, Seo SW, Kim KM, et al. Clinical and radiographic results of lateral condylar fracture of distal humerus in children. J Pediatr Orthop, 2010, 30(5): 425-429.
3.	Canale ST. 坎贝尔骨科手术学. 卢世璧, 主译. 3版. 济南: 山东科学技术出版社, 2003: 2358.
4.	Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of humerus in children. Sixteenyears’ experience with long-term follow-up. J Bone Joint Surg (Am), 1974, 56(2): 263-272.
5.	郭跃明, 王志远, 邹勇根, 等. 肱骨髁上骨折并发肘内翻畸形病理形态学分析. 中国矫形外科杂志, 2004, 12(10): 726-727.
6.	Eren A, Güven M, Erol B, et al. Correlation between posteromedial or posterolateral displacement and cubitus varus deformity in supracondylar humerus fractures in children. J Child Orthop, 2008, 2(2): 85-89.
7.	Mortazavi SM, Heidari P, Asadollahi S, et al. Severe tardy ulnar nerve palsy caused by tuarmatic cubitus valgus deformity: functional outcome of subcutaneous anterior tuansposition. J Hand Surg (Eur), 2008, 33(5): 575-580.
8.	Di Rocco F, Doglietto F, Tufo T, et al. Posttuaumatic immobilization in flexion of a congenital valgus elbow and cubital tunnel syndrom-case report. Surg Neurol, 2009, 71(6): 709-712.
9.	Meyer RA Jr, Tsahakis PJ, Martin DF, et al. Age and ovariectomy impair both the normalization of mechanical properties and the accretion of mineral by the fracture callus in rats. J Orthop Res, 2001, 19(3): 428-435.
10.	Lu C, Miclau T, Hu D, et al. Celluar basis for age-related changes in fracture repair. J Orthop Res, 2005, 23(6): 1300-1307.
11.	Helfet DL, Kloen P, Anand N, et al. Open reduction and internal fixation of delayed unions and nonunions of fractures of the distal part of the humerus. J Bone Joint Surg (Am), 2003, 85-A(1): 33-40.
12.	Butt MF, Dhar SA, Farooq M, et al. Lateral invaginating peg (LIP) osteomy for the correction of post-traumatic cubitus varus deformity. J Pediatr Orthop B, 2009, 18(5): 265-270.
13.	Gong HS, Chung MS, Oh JH, et al. Oblique closing wedge osteotomy and lateral plating for cubitus varus in adults. Clin Orthop Relat Res, 2008, 466(4): 899-906.
14.	Hahn SB, Choi YR, Kang HJ. Corrective dome osteotomy for cubitus varus and valgus in adults. J Shoulder Elbow Surg, 2009, 18(1): 38-43.
15.	Moon MS, Kim SS, Kim ST, et al. Lateral closing wedge osteotomy with or without medialisation of the distal fragment for cubitus varus. J Orthop Surg (Hong Kong), 2010, 18(2): 220-223.
16.	Davids JR, Lamoreaux DC, Brooker RC, et al. Translation step-cut osteotomy for the treatment of posttraumatic cubitus varus. J Pediatr Orthop, 2011, 31(4): 353-365.
17.	Takagi T, Takayama S, Nakamura T, et al. Supracondylar osteotomy of the humerus to correct cubitus varus: do both internal rotation and extension deformities need to be corrected? J Bone Joint Surg (Am), 2010, 92(7): 1619-1626.
18.	Li SH, Li ZH, Cai ZD, et al. Bilateral plate fixation for type C distal humerus fractures: experience at a single institution. Int Orthop, 2011, 35(3): 433-438.

1. Omid R, Choi PD, Skaggs DL. Supracondylar humeral fractures in children. J Bone Joint Surg (Am), 2008, 90(5): 1121-1132.
2. Koh KH, Seo SW, Kim KM, et al. Clinical and radiographic results of lateral condylar fracture of distal humerus in children. J Pediatr Orthop, 2010, 30(5): 425-429.
3. Canale ST. 坎贝尔骨科手术学. 卢世璧, 主译. 3版. 济南: 山东科学技术出版社, 2003: 2358.
4. Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of humerus in children. Sixteenyears’ experience with long-term follow-up. J Bone Joint Surg (Am), 1974, 56(2): 263-272.
5. 郭跃明, 王志远, 邹勇根, 等. 肱骨髁上骨折并发肘内翻畸形病理形态学分析. 中国矫形外科杂志, 2004, 12(10): 726-727.
6. Eren A, Güven M, Erol B, et al. Correlation between posteromedial or posterolateral displacement and cubitus varus deformity in supracondylar humerus fractures in children. J Child Orthop, 2008, 2(2): 85-89.
7. Mortazavi SM, Heidari P, Asadollahi S, et al. Severe tardy ulnar nerve palsy caused by tuarmatic cubitus valgus deformity: functional outcome of subcutaneous anterior tuansposition. J Hand Surg (Eur), 2008, 33(5): 575-580.
8. Di Rocco F, Doglietto F, Tufo T, et al. Posttuaumatic immobilization in flexion of a congenital valgus elbow and cubital tunnel syndrom-case report. Surg Neurol, 2009, 71(6): 709-712.
9. Meyer RA Jr, Tsahakis PJ, Martin DF, et al. Age and ovariectomy impair both the normalization of mechanical properties and the accretion of mineral by the fracture callus in rats. J Orthop Res, 2001, 19(3): 428-435.
10. Lu C, Miclau T, Hu D, et al. Celluar basis for age-related changes in fracture repair. J Orthop Res, 2005, 23(6): 1300-1307.
11. Helfet DL, Kloen P, Anand N, et al. Open reduction and internal fixation of delayed unions and nonunions of fractures of the distal part of the humerus. J Bone Joint Surg (Am), 2003, 85-A(1): 33-40.
12. Butt MF, Dhar SA, Farooq M, et al. Lateral invaginating peg (LIP) osteomy for the correction of post-traumatic cubitus varus deformity. J Pediatr Orthop B, 2009, 18(5): 265-270.
13. Gong HS, Chung MS, Oh JH, et al. Oblique closing wedge osteotomy and lateral plating for cubitus varus in adults. Clin Orthop Relat Res, 2008, 466(4): 899-906.
14. Hahn SB, Choi YR, Kang HJ. Corrective dome osteotomy for cubitus varus and valgus in adults. J Shoulder Elbow Surg, 2009, 18(1): 38-43.
15. Moon MS, Kim SS, Kim ST, et al. Lateral closing wedge osteotomy with or without medialisation of the distal fragment for cubitus varus. J Orthop Surg (Hong Kong), 2010, 18(2): 220-223.
16. Davids JR, Lamoreaux DC, Brooker RC, et al. Translation step-cut osteotomy for the treatment of posttraumatic cubitus varus. J Pediatr Orthop, 2011, 31(4): 353-365.
17. Takagi T, Takayama S, Nakamura T, et al. Supracondylar osteotomy of the humerus to correct cubitus varus: do both internal rotation and extension deformities need to be corrected? J Bone Joint Surg (Am), 2010, 92(7): 1619-1626.
18. Li SH, Li ZH, Cai ZD, et al. Bilateral plate fixation for type C distal humerus fractures: experience at a single institution. Int Orthop, 2011, 35(3): 433-438.

Chinese Journal of Reparative and Reconstructive Surgery

DOUBLE VOLUME INTERNAL FIXATION FOR CORRECTION OF ADULT POST-TRAUMATIC CUBITUS VARUS

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