Department of Orthopaedic Surgery, Wonkwang University Sanbon Hospital, Gunpo, Korea.
J Shoulder Elbow Surg. 2011 Sep;20(6):866-72. doi: 10.1016/j.jse.2011.04.003. Epub 2011 Jul 20.
We reviewed the results of corrective osteotomy for cubitus varus in middle-aged patients to investigate whether it is recommended in this age group.
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).
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).
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.
我们回顾了中年患者肘内翻矫正截骨术的结果，以探讨在该年龄段是否推荐使用这种方法。
我们研究了 20 例连续接受 3 维矫正截骨术的患者，平均年龄为 47.9 岁（范围，41-55 岁）。8 例患者采用单钢板固定，12 例患者采用双钢板固定。平均随访时间为 23 个月（范围，18-109 个月）。
肱骨-肘-腕角的平均改善从 21.4°（范围，15°-35°）的内翻变为 8.7°（范围，-4°-20°）的外翻。所有患者均在平均 17.5 周（范围，8-36 周）时显示骨愈合。15 例（75%）患者出现超过 12 周的延迟愈合。单钢板组的平均愈合时间为 21.0 周，双钢板组为 15.1 周（P =.012）。2 例采用单钢板固定的患者发生固定失败。术前和术后的活动弧相似。根据 Oppenheim 标准，结果为优 10 例，良 8 例，差 2 例。平均最终 Mayo 肘功能评分 90.3 分（范围，70-100 分）。
对于中年患者的肘内翻，可以采用闭合楔形截骨术和双钢板固定。尽管截骨愈合倾向于延迟，但这种方法可提供满意的畸形矫正、维持肘部活动度和良好的功能结果。
