Agrawal Orthopaedic Hospital and Research Institute, Gorakhpur.
Department of Orthopaedics, Rohilkhand Medical College, Bareilly, Uttar Pradesh.
J Pediatr Orthop B. 2022 Jan 1;31(1):31-42. doi: 10.1097/BPB.0000000000000845.
The term cubitus varus describes the inward inclination of the supinated forearm on the extended elbow. The deformity manifests clinically as a decreased carrying angle, decreased range of motion (ROM) along with a cosmetically unsightly appearance. The aim of the present study was to evaluate the technique of compression-distraction osteogenesis using the Ilizarov apparatus in the management of patients with post-traumatic cubitus varus deformity. The objectives were to study the impact of this method on the ROM, the Humerus Elbow Wrist (HEW) angle as well as the Lateral Prominence Index. A total of 32 patients who presented with a cubitus varus deformity of ≥10° at the elbow were retrospectively analyzed using data retrieved from a computerized hospital database. All patients had undergone a mini-incision subperiosteal osteotomy followed by application of an Ilizarov frame. Cinico-radiological follow-up was carried out at regular intervals until union was achieved and yearly thereafter. The mean time to union was 11 weeks. The mean follow-up period ranged from 2 to 12 years (mean 4.0 years). Results were graded as excellent in 25 cases (78.1%), good in 2 (6.3%) and poor in 5 case (15.6%) using the grading system of Oppenheim. The mean HEW angle at final follow-up improved from 20° of varus to 6° of valgus. The mean flexion/extension improved from 121°/-3° preoperatively to 125°/-4° at final follow-up. The Mayo Elbow Performance scores at final follow-up were excellent in 23 cases, good in 7 and fair in 2. Complications encountered included superficial pintract infections in three cases, lateral condylar prominence in one case, loss of terminal flexion in three cases and valgus over-correction in one case.
尺骨内翻描述的是旋前的前臂在伸直的肘部向内倾斜。这种畸形在临床上表现为携带角减小，活动范围（ROM）减小，同时外观不美观。本研究旨在评估使用伊利扎罗夫（Ilizarov）器械进行加压-牵张成骨术治疗创伤后尺骨内翻畸形患者的技术。目的是研究该方法对 ROM、肱骨肘腕（HEW）角以及外侧突出指数的影响。共对 32 例肘部尺骨内翻畸形≥10°的患者进行回顾性分析，这些数据来自计算机化医院数据库。所有患者均接受小切口骨膜下截骨术，然后应用伊利扎罗夫框架。定期进行临床和放射学随访，直到愈合，此后每年随访一次。愈合的平均时间为 11 周。平均随访时间为 2 至 12 年（平均 4.0 年）。根据 Oppenheim 分级系统，25 例（78.1%）结果为优，2 例（6.3%）为良，5 例（15.6%）为差。最终随访时的平均 HEW 角从内翻的 20°改善为外翻的 6°。平均屈伸从术前的 121°/-3°改善到最终随访时的 125°/-4°。最终随访时的 Mayo 肘部功能评分优 23 例，良 7 例，可 2 例。并发症包括 3 例浅表皮钉道感染，1 例外侧髁突出，3 例终末屈曲丧失和 1 例外翻过度矫正。
