Lateral closing wedge osteotomy with or without medialisation of the distal fragment for cubitus varus.

Abstract

To compare treatment outcomes after closing wedge osteotomy and plate fixation for cubitus varus deformity undertaken with or without medialisation of the distal fragment. Records of 21 men and 16 women aged 20 to 34 years who underwent closing wedge osteotomy and plate fixation for cubitus varus deformity with (n=21) or without (n=16) medialisation of the distal fragment were reviewed. A daily alternate flexion-extension splinting was applied for one week for early restoration of full range of motion. The carrying angle and range of motion of the elbow were measured. All patients regained the normal carrying angle and range of motion; none had loss of fixation or limitation in range of motion exceeding 10 degrees. Outcomes were excellent in 23 patients and good in 9. A small bony prominence over the lateral condylar region ('lazy S' deformity) was noted in group-1 but not group-2 patients. Closing wedge supracondylar osteotomy with medialisation of the distal fragment was an effective treatment for cubitus varus deformity and minimised the risk of 'lazy S' deformity.