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Oblique Closing Wedge Osteotomy and Lateral Plating for Cubitus Varus in Adults

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Clinical Orthopaedics and Related Research

Abstract

Corrective osteotomy around the elbow can require longer recovery time in adults than in children because of the longer healing period and the propensity for stiffness. We hypothesized a lateral oblique closing wedge osteotomy with a larger contact area and fixation with a lag screw plus early motion would provide stable fixation and early motion recovery in adults with cubitus varus deformity. Twelve consecutive patients who needed surgery were treated using this procedure. They were allowed active motion exercises 1 week postoperatively. The age of the patients at the time of surgery averaged 39 years (range, 31–48 years). The minimum followup was 15 months. All patients achieved healing of the osteotomy, and regained preoperative arcs of elbow motion at a mean of 7.3 weeks (range, 2–12 weeks) postoperatively. The average humerus-elbow-wrist angle improved from −23.3° to 8° (p < 0.002) by a mean gain of 29.6°. The mean lateral prominence index did not increase postoperatively. The final MEPI and DASH score averaged 95.4 points and 5.5 points. No patient experienced nerve palsy. Oblique osteotomy and fixation with a lag screw and lateral plating is a reasonable alternative technique for cubitus varus in adults, with early recovery of elbow motion and satisfactory deformity correction.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Sang Mi Shim and Dr Sang Ik Shin for their skillful contributions to this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea

    Hyun Sik Gong MD, PhD, Moon Sang Chung MD, PhD, Joo Han Oh MD, PhD, Hoyune Esther Cho & Goo Hyun Baek MD, PhD

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  1. Hyun Sik Gong MD, PhD
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  2. Moon Sang Chung MD, PhD
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  3. Joo Han Oh MD, PhD
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  4. Hoyune Esther Cho
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  5. Goo Hyun Baek MD, PhD
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Correspondence to Hyun Sik Gong MD, PhD.

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Each author certifies that he has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the reporting of these cases, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participating in the study was obtained.

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Gong, H.S., Chung, M.S., Oh, J.H. et al. Oblique Closing Wedge Osteotomy and Lateral Plating for Cubitus Varus in Adults. Clin Orthop Relat Res 466, 899–906 (2008). https://doi.org/10.1007/s11999-008-0164-0

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  • DOI: https://doi.org/10.1007/s11999-008-0164-0

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