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Oblique Close Wedge versus Modified Step Cut Osteotomy for Cubitus Varus Deformity in Children: A Prospective
Udit Sourav Sahoo1, Prajnadipta Rout2, Suman Sourav Mishra3
1Department of Orthopaedics, SCB Medical College, Cuttack, Odisha, India.
Insights
Oblique closing-wedge and modified step-cut osteotomies effectively correct cubitus varus in children. Both surgical techniques demonstrate comparable radiological and functional outcomes, offering safe and reliable treatment options for this pediatric deformity.
Area of Science:
- Pediatric Orthopedics
- Surgical Techniques
- Pediatric Trauma Complications
Background:
- Cubitus varus is a common consequence of untreated pediatric supracondylar humerus fractures.
- Effective surgical correction is crucial for restoring elbow function and aesthetics.
- Limited prospective comparative data exist for commonly used osteotomy techniques.
Purpose of the Study:
- To prospectively compare the efficacy of oblique closing-wedge osteotomy versus modified step-cut osteotomy for correcting pediatric cubitus varus.
- To evaluate and compare radiological and functional outcomes between the two surgical methods.
Main Methods:
- A prospective, non-randomized comparative study involving 30 pediatric patients with cubitus varus deformity.
- Patients were divided into two groups: 15 undergoing oblique closing-wedge osteotomy and 15 undergoing modified step-cut osteotomy.
- Assessment included post-operative carrying angle, elbow range of motion, Mayo Elbow Performance Score (MEPS), and union time.
Main Results:
- Both osteotomy groups achieved significant correction of cubitus varus deformity.
- No statistically significant differences were observed in post-operative carrying angles, MEPS, range of motion, or union time between the groups.
- All osteotomies demonstrated successful radiological union with a mean follow-up of 14.2 months.
Conclusions:
- Both oblique closing-wedge and modified step-cut osteotomies are effective and comparable surgical options for correcting cubitus varus in children.
- These techniques offer reliable radiological and functional results, indicating their safety and efficacy in pediatric patients.
Introduction:
Cubitus varus is a delayed complication of neglected supracondylar humerus fractures in children. Both oblique closing-wedge and modified step-cut osteotomies are widely used corrective techniques, but prospective comparative data are limited.
Materials And Methods:
In this prospective non-randomized comparative study, 30 patients with cubitus varus deformity were divided into two groups: Oblique closing-wedge osteotomy (Group 1, n = 15) and modified step-cut osteotomy (Group 2, n = 15). Radiological correction was assessed using carrying angle, and functional outcomes were evaluated using elbow flexion- extension arc, prono-supination arc, and Mayo elbow performance score (MEPS). Radiological union time was recorded. Statistical analysis was performed using an independent t-test and Chi-square test.
Results:
The mean age was 14.9 ± 2.7 years, with comparable baseline characteristics between groups (P = 0.741). Both groups showed significant deformity correction, with mean post-operative carrying angles of 13.0° ± 4.9° and 11.5° ± 5.6°, respectively (P = 0.432). The mean MEPS was 88.0 ± 7.8 in Group 1 and 90.0 ± 8.7 in Group 2 (P = 0.511). Elbow flexion extension arc, prono-supination arc, and union time were similar between groups (P > 0.05). Both the osteotomies achieved radiological union. The mean follow-up duration was 14.2 ± 2.8 months.
Conclusion:
Both oblique closing-wedge and modified step-cut osteotomies provide effective correction of cubitus varus with comparable radiological and functional outcomes. Both techniques are safe and reliable options in children.
