Results of supracondylar osteotomy and bone fixation with the Ilizarov apparatus for cubitus varus and valgus deformities
Introduction Cubitus varus denotes the inward deviation of the supinated forearm on the extended elbow. In cubitus valgus, the forearm is angled away from the body with the arm fully extended. Both deformities manifest clinically as an abnormal carrying angle, along with a cosmetically unsightly a...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
2025-06-01
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| Series: | Гений oртопедии |
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| Summary: | Introduction Cubitus varus denotes the inward deviation of the supinated forearm on the extended elbow.
In cubitus valgus, the forearm is angled away from the body with the arm fully extended. Both deformities
manifest clinically as an abnormal carrying angle, along with a cosmetically unsightly appearance,
with or without restricted range of motion (ROM).
The aim of the study is to evaluate the results of one-stage supracondylar corrective osteotomy and bone fixation
using the Ilizarov apparatus in varus and valgus deformities of the elbow joint, using the angulation‑translation
principle (osteotomy rule 2); to determine the effect of this method on the humerus-elbow-wrist angle (HEW),
ODD and lateral prominence index (LPI).
Materials and Methods A total of 12 patients, age ranging from 7–24 years, who presented with cubitus varus
of ≥ 10° (n = 9) and cubitus valgus (n = 3) of ≥ 20°, were included in the study. All patients underwent acute
correction using a mini-incision, supracondylar osteotomy and fixation with the Ilizarov frame.
Results The mean time to union was 14.2 weeks (range, 11–18 weeks). The average duration of follow-up was
24 months. Functional outcome was graded as excellent in 9 cases (75 %), good in 2 (17 %) cases and poor
in 1 case (8 %) using the grading system of Oppenheim. For cubitus varus, the mean HEW angle improved
significantly, from (–15.5 ± 4.2) pre-operatively to (8.2 ± 1.5) post-operatively. For cubitus valgus, the mean
HEW angle was (28.3 ± 5.3) pre-operatively, which improved to (14.1 ± 3.1) post-operatively, which was
statistically significant. Complications encountered included superficial pin-tract infection in 1 case, lateral
condylar prominence in 1 case and complete radial nerve palsy in 1 case.
Discussion Conventional methods of treatment of cubitus varus or valgus include various corrective
osteotomies, typically stabilized with internal fixation. Despite being successful, a substantial number
of distressing complications have been reported with the use of internal fixation. The mandatory requirement
of post-operative immobilization, resulting in stiffness and disuse atrophy, is a deterrent to the use of internal
hardware, which can be easily circumvented by the versatility of the Ilizarov apparatus.
Conclusion External fixation with the Ilizarov apparatus is a versatile means of correction of cubitus varus
and valgus. It precisely achieves the desired carrying angle and cosmetic appearance of the elbow. It facilitates
residual adjustments in under/over-corrected scenarios. The stability is indisputable. Early joint mobilization
leads to an improved functional outcome. |
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| ISSN: | 1028-4427 2542-131X |