From the Department of Orthopaedic Biomaterial Science (Dr. Oka) and the Department of Orthopaedic Surgery (Dr. Oka, Dr. Shiode, Dr. Iwahashi, Dr. Kazui, Dr. Yamamoto, Dr. Miyake, Dr. Miyamura, and Dr. Tanaka), Graduate School of Medicine, Osaka University, Osaka, Japan; the Department of Orthopaedic Surgery, Bellland General Hospital, Sakai, Japan (Dr. Murase); and the Department of Sports Medical Science, Graduate School of Medicine, Osaka University, Osaka, Japan (Dr. Tanaka).
J Am Acad Orthop Surg Glob Res Rev. 2024 Oct 14;8(10). doi: 10.5435/JAAOSGlobal-D-24-00272. eCollection 2024 Oct 1.
Cubitus varus deformity is primarily a cosmetic complaint that causes some early and late complications. However, no studies have reported the cubitus varus deformity regarding the frequency of complications, relationship to the degree of deformity, and period from the occurrence of the initial injury.
Overall, 83 patients with cubitus varus deformity were examined. The differences in the humerus-elbow-wrist angle (∆HEW-A), tilting angle (∆TA), and internal rotation angle (∆IRA) between the affected and normal sides were measured to determine varus and extension and internal rotation deformity. The period from the occurrence of the initial injury to the evaluation date was also investigated. Multivariate logistic regression analysis was conducted to identify the explanatory variables (period, ∆HEW-A, ∆TA, and ∆IRA) independently associated with complication events. Receiver-operating characteristic curve analysis was also conducted to predict the risk of events.
∆HEW-A was independently associated with the risk of cosmetic complaint (odds ratio [OR], 1.171; 95% confidence interval [95% CI], 1.056 to 1.336) and instability (OR, 1.111; 95% CI, 1.028 to 1.200). ∆TA was independently associated with the risk of limited elbow motion (OR, 1.176; 95% CI, 1.077 to 1.285) and sports disability (OR, 0.892; 95% CI, 0.836 to 0.952). The period from the occurrence of the initial injury was independently associated with risk of pain (OR, 1.063; 95% CI, 1.019 to 1.108), ulnar nerve neuropathy (OR, 1.065; 95% CI, 1.011 to 1.125), and osteoarthritis (OR, 1.188; 95% CI, 1.098 to 1.286). The receiver-operating characteristic curve analysis revealed the optimal cutoffs of 20° and 27° for ∆HEW-A to predict cosmetic complaint and instability; of 25° for ∆TA to predict limited elbow motion; and of 8.8, 8.0, and 16.0 years for the period to predict pain, ulnar nerve neuropathy, and osteoarthritis, respectively.
The treatment of cubitus varus deformity should be determined because a residual deformity >20° of varus and 25° of extension could develop risk of complications over time.
肘内翻畸形主要是一种美容投诉，会导致一些早期和晚期并发症。然而，目前尚无研究报告关于肘内翻畸形的并发症频率、与畸形程度的关系以及从初次损伤发生到评估日期的时间。
共检查了 83 例肘内翻畸形患者。测量患侧与健侧的肱骨-肘-腕角（∆HEW-A）、倾斜角（∆TA）和内旋角（∆IRA）的差异，以确定内翻和伸直及内旋畸形。还研究了从初次损伤发生到评估日期的时间。进行多变量逻辑回归分析，以确定与并发症事件相关的解释变量（时间、∆HEW-A、∆TA 和 ∆IRA）。还进行了受试者工作特征曲线分析，以预测事件的风险。
∆HEW-A 与美容投诉（优势比[OR]，1.171；95%置信区间[95%CI]，1.056 至 1.336）和不稳定性（OR，1.111；95%CI，1.028 至 1.200）的风险独立相关。∆TA 与肘部运动受限（OR，1.176；95%CI，1.077 至 1.285）和运动障碍（OR，0.892；95%CI，0.836 至 0.952）的风险独立相关。从初次损伤发生到评估日期的时间与疼痛（OR，1.063；95%CI，1.019 至 1.108）、尺神经神经病（OR，1.065；95%CI，1.011 至 1.125）和骨关节炎（OR，1.188；95%CI，1.098 至 1.286）的风险独立相关。受试者工作特征曲线分析显示，∆HEW-A 的最佳截断值为 20°和 27°，可预测美容投诉和不稳定性；∆TA 的最佳截断值为 25°，可预测肘部运动受限；时间的最佳截断值分别为 8.8、8.0 和 16.0 年，可预测疼痛、尺神经神经病和骨关节炎。
肘内翻畸形的治疗应根据残余畸形来确定，因为>20°的内翻和>25°的伸直畸形会随着时间的推移产生并发症的风险。
