Management of cubitus varus deformity with Supracondylar dome osteotomy in children :

Abstract

Introduction:

Cubitus varus deformity is among the late complications following supracondylar fractures of the distal humerus in the children, with significant aesthetic concerns for patients and their families. Traditional corrective procedures like lateral closing wedge osteotomy have shown unsatisfactory outcomes due to complications such as neuropraxia and unsightly scarring. Dome osteotomy has emerged as a promising alternative, offering advantages in addressing deformities while minimizing complications.

 Materials and methods:

A prospective study has been performed from March 2021 to April 2023 at Saveetha Medical College and Hospital, Chennai, involving 10 pediatric patients with cubitus varus deformity who underwent dome osteotomy. Preoperative assessment included radiographic evaluation and identification of osteotomy sites. The surgical technique involved meticulous osteotomy, correction of deformity, and fixation using K-wires and mini external fixators. Postoperative care included early mobilization and regular follow-up.

 Results :

Results showed favorable outcomes in terms of cosmetic appearance and functional improvement. Six patients achieved excellent outcomes, 3 had better outcomes, and 1 patient experienced a fair outcome. Flexion improved postoperatively, with no significant complications observed except for transient ulnar neuropraxia in one patient.

The discussion highlights the effectiveness of dome osteotomy in correcting cubitus varus deformity while minimizing complications associated with traditional methods. The procedure offers superior cosmetic outcomes and functional restoration, making it a valuable option for pediatric patients with this condition.

 Conclusion:

 Dome osteotomy is a straightforward, safe, and effective process which ensures a near-normal cosmetic outcome while preventing lateral condyle prominence.