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Translation step-cut osteotomy for posttraumatic Cubitus Varus in adults: a retrospective study
Jung Ryul Kim1, Yoong Jae Moon2, Sung Il Wang3
1Department of Orthopaedics Surgery, Jeonbuk National University Medical School, Research Insitute for Endocrine Sciences and Research Insitute of Clinical Medicine of Jeonbuk National University-Biomedical Research Insitute of Jeonbuk National University Hospital, 567 Baekje-ro, Dukjin-gu, Jeonju, 561-756, Republic of Korea.
Background:
Cubitus varus is a complex three-dimensional deformity. Various osteotomies have been introduced to correct this complex deformity. The objective of the present study was to evaluate clinical and functional outcomes of adult cubitus varus deformity treated with translation step-cut osteotomy.
Methods:
Seventeen consecutive patients with a mean age of 25 years (range, 19-50 years) who underwent translation step-cut osteotomy were enrolled in this study. Their average follow-up period was 28.2 months. Radiographic measurements preoperatively, 3-month postoperatively, and at the last follow-up were compared. Functional outcomes were assessed using Disabilities of the Arm, Shoulder and Hand (DASH), Mayo Elbow Performance Score (MEPS), and Oppenheim criteria.
Results:
The mean humerus-elbow-wrist angle improved from 14.7° ± 6.4° (range, 6°-23°) varus preoperatively to 12.1° ± 6.6° (range, 5°-20°) valgus postoperatively (p < 0.001). The lateral prominence index improved 9.6% from its preoperative value, showing no significant difference from that of a normal elbow. Osseous union was radiographically demonstrated in 16 patients (except one out of 17 patients) within a mean of 12.7 weeks (range, 8-18 weeks). The motion arc of the elbow at the last follow-up was not significantly (p > 0.05) different from that at the initial presentation. Based on Oppenheim criteria, results were excellent for 7, good for 8, and poor for 2 patients. Mean final DASH value and MEPS were 2.5 ± 3.8 points (range, 0-15 points) and 97.0 ± 5.8 points (range, 85-100 points), respectively. With regard to complications, one case had delayed union and one case had transient radial nerve injury.
Conclusion:
Translation step-cut osteotomy using Y plate is an efficient procedure to correct varus alignment and flexion-extension deformities so that they are within normal limits of adults with post-traumatic cubitus varus deformity.
Trial Registration:
Institutional Review Board of Jeonbuk National University Hospital (IRB No. 2020-01-020 ).
