Cubitus Varus

Incidence

 

Occurs 10% of supracondylar humeral fractures

- varus malunion

 

Lateral condyle fracture

- AVN trochlea

 

Elbow Cubitus Varus

 

Growth arrest of medial aspect physis

- rare

- post traumatic

 

Effects

 

Usually little functional defect

 

Cosmetic problem

- appearance can be unacceptable to parents and child

 

NHx

 

Does not correct with time

 

Operative Management

 

1.  Lateral closing wedge osteotomy of the supracondylar region 

- perform at skeletal maturity

- metaphyseal not diaphyseal

- preserve medial cortex

- beware abnormal position of radial nerve (passes through callous)

- 1mm of wedge for each degree

- fixation with plate

 

2.  Complex Osteotomies

- posterior approach

- bilateral plates

- for severe deformities

 

Elbow post distal Osteotomy

 

3.  Young patient / open physis

- guided growth

- application lateral 8 plate