Supracondylar Dome Osteotomy for Post-traumatic Cubitus Varus in Children: A Retrospective Study

Abstract

OBJECTIVE: Cubitus varus is a frequent sequela of pediatric supracondylar humerus fractures and presents with varus malalignment, extension, and internal rotation of the elbow. Although often regarded as a cosmetic deformity, it can lead to significant functional impairments, including chronic pain, ulnar nerve palsy, and posterolateral elbow instability.We retrospectively analyzed the effectiveness of supracondylar dome osteotomy in restoring alignment and function in children with post-traumatic cubitus varus. METHODS: Medical records of 18 children aged over five years who underwent supracondylar dome osteotomy for cubitus varus between 2022 and 2024 were reviewed and analyzed at a tertiary care center. Exclusions included non-traumatic deformity, prior ipsilateral surgery, neurovascular involvement, or incomplete data. Pre- and postoperative assessments included humerus-ulnar angle (HUA), elbow range of motion (ROM), lateral condylar prominence index (LCPI), and functional outcomes using standardized scoring systems. RESULTS: Mean age was 10.72±2.89 years, with predominantly (72.2%) male patients. The mean injury-to-surgery duration was 17.4±5.8 months. Most cases involved the left elbow (61.1%). Significant radiographic correction was achieved, with mean HUA improving from -12.93° ± 2.9° (varus) to 9.11° ± 2.49° (p< 0.001). Range of motion improved from a mean of 117.5° ± 11.28° flexion/9.3° ± 4.6° extension to 131.9° ± 8.0° flexion/3.68° ± 3.65° extension (p< 0.005). The LCPI normalized from -7.66% ± 6.56% to 10.13% ± 7.34% (p< 0.0001), while functional scores demonstrated a trend toward better outcomes. The majority of patients achieved excellent (83.33%) or good results (16.67%), with no reported poor outcomes. CONCLUSION: Dome osteotomy is a safe and effective treatment for post-traumatic cubitus varus in children, reliably restoring alignment with excellent functional results and minimal complications.