Lateral closing wedge supracondylar humeral osteotomy for treatment of post-traumatic cubit's varus

الملخص EN

Objective : To evaluate the results of lateral closing wedge humeral osteotomy and K-wire fixation following isolation and protection of the ulnar nerve when used to correct cubitus varus deformity.

Methods : Forty-one cases of cubitus varus deformity following supracondylar fractures of the humerus were operated by lateral closing wedge osteotomy of the humerus during February 1999 to June 2007 at King Hussein Medical Center.

The mean age of the patients at the time of corrective surgery was 7.2 years (range 4.7-12.3 years).

The osteotomy was internally fixed with two crossed, smooth, K-wires.

After surgery, the patients were observed closely for more than one and half year.

We compared preoperative and postoperative humerus-elbow-wrist angle, range of motion, and carrying angle for all patients.

The results were evaluated according to the criteria of Oppenheim et al.

Results : There were 36 excellent, four good and one poor result.

The average amount of correction of the humerus-elbow-wrist angle was 24.3° and the carrying angle was 25.5°.

Preoperatively, the range of motion averaged 4.7° of extension to 125° of flexion, to a mean postoperative range of motion of 4° of extension and 123° of flexion.

The only one poor result was due to early removal of the K-wires.

However, in all patients, the desired range of motion, good alignment, and complete union of the bone were achieved.

Conclusion : We report that lateral closing wedge supracodylar humeral osteotomy to correct post-traumatic cubitus varus through posterior approach with isolation and direct vision control of the ulnar nerve is relatively safe, simple and effective procedure with low rate of complications, which is important in a procedure performed purely for cosmetic indication.