Various Corrective Osteotomy Techniques for Cubitus Varus in Children: Systematic Review

Area of Science:

• Pediatric Orthopedics
• Surgical Techniques
• Biomechanical Analysis

Background:

• Supracondylar humerus fractures are common pediatric injuries.
• Malunion can lead to cubitus varus deformity.
• Various corrective osteotomy techniques exist for cubitus varus.

Purpose of the Study:

• To systematically review and determine the most effective corrective osteotomy technique for pediatric supracondylar humerus malunion.
• To provide an up-to-date review on surgical interventions for this condition.

Main Methods:

• Systematic literature search of multiple databases (PubMed, EMBASE, etc.) following PRISMA guidelines.
• Independent review of 39 selected articles involving 863 patients.
• Quality and bias assessment using Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool.

Main Results:

• Included 39 studies with 863 patients, average follow-up of 27.3 months.
• Collected data on range of motion, angle correction, and clinical outcomes.
• Identified complications including infections, nerve injuries, and residual deformity; noted a shortage of RCTs.

Conclusions:

• Multiple osteotomy techniques (lateral closing wedge, step-cut, dome, distraction osteogenesis, 3D osteotomy) yield favorable outcomes.
• Lateral closing wedge osteotomy is advised for range of motion deficits.
• Step-cut osteotomy is superior for humerus-elbow-wrist angle correction; meta-analysis favored lateral closing wedge over dome osteotomy.