Translation Step-Cut Osteotomy Versus Pentagonal Osteotomy for Pediatric Cubitus Varus Deformity: Does Dual-Triangle...

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Limb deformity correction

Background:

• Post-traumatic cubitus varus is a 3D deformity causing cosmetic and functional issues.
• Translation step-cut osteotomy (TSCO) corrects deformity but may leave lateral condylar prominence.
• Pentagonal osteotomy is a modified technique to improve medial translation and contour.

Purpose of the Study:

• To prospectively compare clinical, radiologic, and cosmetic outcomes of TSCO versus pentagonal osteotomy for pediatric cubitus varus.
• To evaluate the effectiveness of pentagonal osteotomy in enhancing medial translation and cosmetic contour compared to TSCO.

Main Methods:

• Prospective comparative study of 24 children (<16y) with post-traumatic cubitus varus, randomized to TSCO (n=12) or pentagonal osteotomy (n=12).
• Minimum 12-month follow-up assessing range of motion, carrying angle, Baumann angle, HEW angle, LPI, and cosmetic/functional outcomes (Barrett, Oppenheim criteria).

Main Results:

• Both techniques significantly corrected deformity and improved carrying and HEW angles without intergroup differences.
• Lateral prominence index improved in both groups, with a trend towards greater improvement in the pentagonal group (P=0.174).
• TSCO showed a statistically significant advantage in reducing extension deficit (P=0.046); cosmetic satisfaction was high in both (83.3% TSCO, 91.7% pentagonal).

Conclusions:

• TSCO and pentagonal osteotomy are safe and effective for pediatric cubitus varus, yielding comparable outcomes.
• Further studies with larger cohorts and longer follow-up are necessary to ascertain potential long-term advantages of pentagonal osteotomy.