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Shortening dome osteotomy for correction of severe cubitus varus secondary to malunited supracondylar fractures in children

  • Orthopaedic Surgery
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Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Summary of background data

The results of conventional corrective procedures remain suboptimal for severe cubitus varus deformities (> 30°) in children. We present the results of shortening dome osteotomy for the correction of such deformities.

Patients and methods

We present retrospective review of prospectively collected data of 18 patients (11 boys and 7 girls) who underwent shortening dome osteotomy between January 2011 and December 2019 for severe cubitus varus deformities (> 30°) secondary to malunited supracondylar fracture. The procedure involved the removal of convexo-concave bone (5–8 mm wide) between the two domes. Humero-ulnar angles, lateral condylar prominence index (LCPI), and elbow range of movements were recorded preoperatively and postoperatively.

Results

Mean age was 7.5 years (range 5 years–11 years). Indication for surgery was poor cosmesis in all the patients and tardy ulnar nerve symptoms in three patients. Mean preoperative humero-ulnar angle was 26.1° varus (range 22°–34°), while it was 7.1° valgus (range 0°–12°) for contralateral normal elbow. They were followed for a mean duration of 2.2 years (range 12 months–5.8 years). The mean postoperative valgus angle achieved was 7.3° (range 2°–12°) as total angular correction achieved was 34.4° (range 30°–44°) (p < 0.001). Radiological healing was observed in all the patients at mean duration of 7.1 weeks (range 5 weeks–9 weeks). Mean preoperative and postoperative LCPI were − 2.4 (range +4.7 to − 10.5) and − 1.7 (range +4.5 to − 5.1), respectively (p = 0.595). Three patients had pin tract infections and two of them responded to aseptic dressings and oral antibiotics, while another required early pin removal and additional protection in splint. All patients regained preoperative arc of motion within 6 months after the procedure.

Conclusion

Shortening dome osteotomy is a safe and effective method for correcting severe cubitus varus deformities (> 30°) secondary to malunited supracondylar fracture in children.

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Acknowledgements

The manuscript has been read and approved by all the authors and requirement for authorship of this document has been met. Each author certifies that the work and all investigations were conducted in conformity with ethical principles of research. Each author believes that the manuscript represents honest work. They did not receive grants from any commercial entity in support of this work. Each author certifies that he has no commercial associations (e.g., consultancies, stock ownership, equity interest, and patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted article.

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No funding was received by any of the authors/their family members.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi, 110002, India

    Pritish Singh, Sumit Arora, Rohan Mehta & Vinod Kumar

  2. Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, Delhi, 110029, India

    Anant Krishna

  3. Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Associated Safdarjung Hospital, New Delhi, 110029, India

    Vikas Gupta

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  1. Pritish Singh
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  2. Anant Krishna
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  3. Sumit Arora
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  6. Vinod Kumar
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Correspondence to Sumit Arora.

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Singh, P., Krishna, A., Arora, S. et al. Shortening dome osteotomy for correction of severe cubitus varus secondary to malunited supracondylar fractures in children. Arch Orthop Trauma Surg 143, 1371–1378 (2023). https://doi.org/10.1007/s00402-021-04288-y

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