Department of Orthopaedics, Hunan Children's Hospital.
Department of Orthopaedics, The Third Hospital of Changsha, Yuhua, Changsha, HN, China.
J Pediatr Orthop. 2023 Jul 1;43(6):355-361. doi: 10.1097/BPO.0000000000002389. Epub 2023 Mar 13.
Cubitus varus deformity is a complex 3-dimensional deformity. Various osteotomies have been introduced to correct this deformity, however, there is no consensus on the best procedure to correct the deformity while avoiding complications. In this retrospective study, we used a modified inverse right-angled triangle osteotomy to treat 22 children with posttraumatic cubitus varus deformity. The primary objective was to evaluate this technique by presenting its clinical and radiologic results.
Twenty-two consecutive patients with a cubitus varus deformity underwent a modified reverse right-angled triangle osteotomy between October 2017 and May 2020 and were then followed for a minimum of 24 months. We evaluated its clinical and radiologic results. Functional outcomes were assessed using Oppenheim criteria.
The average follow-up period was 34.6 months (range, 24.0 to 58.1 months). The mean range of motion was 4.32 degrees (range, 0 degrees to 15 degrees)/122.73 degrees (range, 115 degrees to 130 degrees) (hyperextension/flexion) before surgery and 2.05 degrees (range, 0 degrees to 10 degrees)/127.27 degrees (range, 120 degrees to 145 degrees) at the final follow-up. There were significant ( P < 0.05) differences between the flexion and hyperextension angles before surgery and at the final follow-up. Based on Oppenheim criteria, results were excellent for 20, good for 2, and none of the patients had poor results. The mean humerus-elbow-wrist angle improved from 18.23 degrees (range, 10 degrees to 25 degrees) varus preoperatively to 8.45 degrees (range, 5 degrees to 15 degrees) valgus postoperatively ( P < 0.05). The mean of the preoperative lateral condylar prominence index was 3.52 (range, 2.5 to 5.2) and the average postoperative lateral condylar prominence index was -3.28 (range, -1.3 to -6.0). All patients were pleased with the overall appearance of their elbows.
The modified reverse right-angled triangle osteotomy can precisely and stably correct the deformity in the coronal and sagittal planes, we recommend this technique as a simple, safe, and reliable correction of cubitus varus deformity.
Level IV; case series; therapeutic studies-investigating the results of treatment.
肘内翻畸形是一种复杂的三维畸形。已经引入了各种截骨术来矫正这种畸形，但是，在避免并发症的同时，哪种手术方法是最好的，还没有达成共识。在这项回顾性研究中，我们使用改良的反向直角三角形截骨术治疗了 22 例创伤后肘内翻畸形患儿。主要目的是通过介绍其临床和影像学结果来评估该技术。
2017 年 10 月至 2020 年 5 月，22 例肘内翻畸形患者行改良反向直角三角形截骨术，随访至少 24 个月。我们评估了其临床和影像学结果。使用 Oppenheim 标准评估功能结果。
平均随访时间为 34.6 个月（范围，24.0 至 58.1 个月）。术前平均活动范围为 4.32°（范围，0°至 15°）/122.73°（范围，115°至 130°）（过伸/屈曲），末次随访时为 2.05°（范围，0°至 10°）/127.27°（范围，120°至 145°）。术前和末次随访时的屈曲和过伸角度有显著差异（P<0.05）。根据 Oppenheim 标准，20 例结果为优，2 例结果为良，无一例结果为差。肱骨-肘-腕角从术前的 18.23°（范围，10°至 25°）内翻改善至术后的 8.45°（范围，5°至 15°）外翻（P<0.05）。术前外侧髁突出指数的平均值为 3.52（范围，2.5 至 5.2），术后平均外侧髁突出指数为-3.28（范围，-1.3 至-6.0）。所有患者对肘部的整体外观均满意。
改良的反向直角三角形截骨术可精确、稳定地矫正冠状面和矢状面的畸形，我们推荐该技术作为治疗肘内翻畸形的一种简单、安全、可靠的方法。
IV 级；病例系列；治疗研究-调查治疗结果。
