Corrective osteotomy for cubitus varus in middle-aged patients

• Published in: Journal of shoulder and elbow surgery Vol. 20; no. 6; pp. 866 - 872
• Main Authors: Lim, Tae Kang, MD, Koh, Kyoung Hwan, MD, Lee, Do Kyung, MD, Park, Min Jong, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.09.2011; Elsevier
• Subjects: Adult; Biological and medical sciences; corrective osteotomy; Cubitus varus; Diseases of the osteoarticular system; Female; Humans; Humerus - abnormalities; Humerus - surgery; Male; Medical sciences; Middle Aged; middle-aged patients; Orthopedic surgery; Orthopedics; Osteotomy - methods; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Study; middle-aged patients; Cubitus varus; Level IV; corrective osteotomy; Case Series; Human; Treatment; Varus; Osteotomy; Surgery; Rheumatology
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2011.04.003

Background We reviewed the results of corrective osteotomy for cubitus varus in middle-aged patients to investigate whether it is recommended in this age group. Materials and methods We studied 20 consecutive patients who underwent 3-dimensional corrective osteotomy at an average age of 47.9 years (range, 41-55 years). The osteotomy was fixed with single plating in 8 patients and with double plating in 12. The average follow-up was 23 months (range, 18-109 months). Results The average humerus-elbow-wrist angle improved from 21.4° (range, 15°-35°) varus to 8.7° (range, –4°-20°) valgus. Osseous union was radiographically demonstrated in all patients at an average of 17.5 weeks (range, 8-36 weeks). Delayed union of longer than 12 weeks was observed in 15 patients (75%). The average time to union in the single-plating group was 21.0 weeks compared with 15.1 weeks in the double-plating group ( P = .012). Failure of fixation occurred in 2 patients who had single plating. The preoperative and postoperative arc of motion was similar. According to Oppenheim criteria, results were excellent in 10, good in 8, and poor in 2. The average final Mayo Elbow Performance Score was 90.3 points (range, 70-100 points). Conclusion Cubitus varus in middle-aged patients can be treated by a closing wedge osteotomy and fixation with double plating. This provides satisfactory deformity correction, maintenance of the elbow motion, and good functional outcome, although healing of the osteotomy tends to be delayed.