A Modified Step-Cut (Reverse V) Osteotomy to Treat Posttraumatic Cubitus Varus Deformity.

INTRODUCTION

It is sufficient to correct posttraumatic cubitus varus deformity in only the coronal plane in children under the age of ten years to allow more precise and stable correction, and a modified step-cut (reverse V) osteotomy is one of the best methods.

STEP 1 EXPOSE THE DISTAL PART OF THE HUMERUS: With the patient in a lateral decubitus position, expose the distal part of the humerus both medially and laterally, using gentle retraction to avoid radial nerve palsy.

STEP 2 RESECT BONE: Using a triangular template made prior to surgery, perform the osteotomy.

STEP 3 REDUCE DEFORMITY: Increase the degree of correction to reduce the deformity.

STEP 4 FIXATION AND SKIN CLOSURE: Cross-pin with Kirschner wires, taking care to avoid hyperextension at the osteotomy site.

STEP 5 POSTOPERATIVE MANAGEMENT: Immobilize the elbow with a splint, and permit active motion two to three weeks after surgery.

RESULTS & PREOP/POSTOP IMAGES: Our case series included eight patients (four male and four female). The average age of the patients at the time of the osteotomy was 6.8 years (range, four to fourteen years).

WHAT TO WATCH FOR

IndicationsContraindicationsPitfalls & Challenges.