Davids Jon R, Lamoreaux David Chad, Brooker Reginald Christopher, Tanner Stephanie L, Westberry David E
Shriners Hospital for Children, 950 West Faris Road, Greenville, SC 29601, USA.
J Pediatr Orthop. 2011 Jun;31(4):353-65. doi: 10.1097/BPO.0b013e31821723a6.
Cubitus varus deformity is the most common complication after the treatment of displaced supracondylar humerus fractures.
A retrospective analysis was performed evaluating patients who had undergone a translation step-cut osteotomy for correction of cubitus varus deformity between 1993 and 2008. Postoperative radiographs to union were reviewed for all patients. Subjective information and range of motion measures were documented from the medical records. Patients and their families were also contacted through telephone and administered a questionnaire as well as the QuickDash functional outcome measure to assess their function and satisfaction.
Thirty-seven participants were identified and reviewed. Average age at the time of surgery was 8 years and 10 months, with an average follow-up of 2 years and 4 months. Outcomes were assessed in terms of technical, functional, and satisfaction domains. Technical Domain: Average humeroulnar angle (radiographic carrying angle) correction was 26 degrees. Bauman's angle improved 21 degrees on average in patients who were skeletally immature. Functional Domain: Elbow range of motion was maintained in all planes with few exceptions. The clinical carrying angle improved 26 degrees on average, and was symmetric with the unaffected side in 22 of 25 cases in which it was documented. The QuickDash was applied to 15 participants. Eight participants had perfect scores for the symptoms/disability section, and 7 had scores in the top 20% for function. Satisfaction Domain: A study-specific questionnaire was applied to 16 participants. All patients and parents questioned would recommend the procedure to other parents/patients.
The translation step-cut osteotomy reliably corrects the coronal plane angular deformity associated with cubitus varus, resulting in excellent outcomes in technical, functional, and satisfaction domains. The osteotomy is relatively simple to perform, and is inherently more stable than other proposed methods. It also minimizes the prominence of the lateral condyle associated with simple lateral closing wedge osteotomy.
肘内翻畸形是移位型肱骨髁上骨折治疗后最常见的并发症。
对1993年至2008年间接受平移阶梯截骨术矫正肘内翻畸形的患者进行回顾性分析。对所有患者术后直至骨折愈合的X线片进行复查。从病历中记录主观信息和活动范围测量值。还通过电话联系患者及其家属，并发放问卷以及QuickDash功能结局测量表，以评估其功能和满意度。
共确定并复查了37名参与者。手术时的平均年龄为8岁10个月，平均随访时间为2年4个月。从技术、功能和满意度方面评估结局。技术方面：平均肱尺角（X线携带角）矫正为26度。骨骼未成熟患者的鲍曼角平均改善21度。功能方面：除少数例外，所有平面的肘关节活动范围均得以维持。临床携带角平均改善26度，在有记录的25例病例中有22例与未受影响侧对称。对15名参与者应用了QuickDash。8名参与者在症状/残疾部分得满分，7名参与者在功能方面得分在前20%。满意度方面：对16名参与者应用了一项特定研究的问卷。所有接受询问的患者及其父母均会向其他父母/患者推荐该手术。
平移阶梯截骨术能可靠地矫正与肘内翻相关的冠状面角畸形，在技术、功能和满意度方面均取得优异结局。该截骨术操作相对简单，且本质上比其他提议的方法更稳定。它还能使与单纯外侧闭合楔形截骨术相关的外侧髁突出最小化。
