Abstract：
BACKGROUND: Humeral osteotomy is the best method for treatment of severe cubitus varus in children. Many osteotomy methods have been developed in the past. In this study, we describe a novel corrective technique by applying the principles described by Paley involving lateral osteotomy using Kirschner wires (K-wires). Vertices of the osteotomy should be located at the center of rotation of angulation. The anatomical and mechanical axes can be corrected with precision.
METHODS: In this retrospective study, 21 patients (17 male, 4 female) who fulfilled the study criteria and underwent lateral closing osteotomy for cubitus varus deformity from July 2015 to October 2017 were included into the study. The osteotomy line of all patients was designed according to Paley\'s principles. An isosceles triangle template was made according to the design preoperatively. The lateral osteotomy was made with the assistance of C-arm radiographs. The osteotomy was fixed by K-wires laterally. Patients were followed up, and elbows were evaluated by radiography and using the Mayo Elbow Performance Index (MEPI) score.
RESULTS: The mean correction angle obtained was 32.33°±2.83°. According to the MEPI score assessment, 19 of the 21 patients had an excellent outcome and two had a good outcome. Two patients complained of conspicuous scars; however, no further cosmetic surgery was performed. The range of motion was 135.0° preoperatively and 133.7° postoperatively, showing no significant difference (p = 0.326). None showed evidence of neurovascular injury or complained of prominence of the lateral humerus.
CONCLUSIONS: Paley\'s principles for correcting cubitus varus deformity in children are effective and reliable for treating such a condition.
METHODS: Therapeutic IV.
METHODS: In this retrospective study, 21 patients (17 male, 4 female) who fulfilled the study criteria and underwent lateral closing osteotomy for cubitus varus deformity from July 2015 to October 2017 were included into the study. The osteotomy line of all patients was designed according to Paley\'s principles. An isosceles triangle template was made according to the design preoperatively. The lateral osteotomy was made with the assistance of C-arm radiographs. The osteotomy was fixed by K-wires laterally. Patients were followed up, and elbows were evaluated by radiography and using the Mayo Elbow Performance Index (MEPI) score.
RESULTS: The mean correction angle obtained was 32.33°±2.83°. According to the MEPI score assessment, 19 of the 21 patients had an excellent outcome and two had a good outcome. Two patients complained of conspicuous scars; however, no further cosmetic surgery was performed. The range of motion was 135.0° preoperatively and 133.7° postoperatively, showing no significant difference (p = 0.326). None showed evidence of neurovascular injury or complained of prominence of the lateral humerus.
CONCLUSIONS: Paley\'s principles for correcting cubitus varus deformity in children are effective and reliable for treating such a condition.
METHODS: Therapeutic IV.
摘要：
背景：肱骨截骨术是治疗儿童重度肘内翻的最佳方法。过去已经开发了许多截骨方法。在这项研究中,我们描述了一种新的矫正技术，通过应用Paley描述的原理，涉及使用Kirschner线（K线）进行外侧截骨术。截骨术的顶点应位于成角度的旋转中心。可以精确地校正解剖轴和机械轴。
方法：在这项回顾性研究中，21名患者（17名男性，从2015年7月至2017年10月，符合研究标准并接受了肘内翻畸形外侧闭合截骨术的4名女性）纳入研究。所有患者的截骨线均按照Paley原则设计。术前根据设计制作等腰三角形模板。外侧截骨术是在C臂X光片的帮助下进行的。截骨用K线横向固定。对患者进行了随访,和肘部通过X线照相术并使用Mayo肘部性能指数（MEPI）评分进行评估。
结果:得到的平均校正角为32.33°±2.83°。根据MEPI评分评估，21例患者中有19例预后良好，2例预后良好。两名患者抱怨明显的疤痕；然而，没有进行进一步的整容手术.术前运动范围为135.0°,术后为133.7°,没有显着差异(p=0.326)。没有显示神经血管损伤的证据或抱怨肱骨外侧突出。
结论：佩利纠正儿童肘内翻畸形的原则对于治疗这种疾病是有效和可靠的。
方法：治疗IV。
方法：在这项回顾性研究中，21名患者（17名男性，从2015年7月至2017年10月，符合研究标准并接受了肘内翻畸形外侧闭合截骨术的4名女性）纳入研究。所有患者的截骨线均按照Paley原则设计。术前根据设计制作等腰三角形模板。外侧截骨术是在C臂X光片的帮助下进行的。截骨用K线横向固定。对患者进行了随访,和肘部通过X线照相术并使用Mayo肘部性能指数（MEPI）评分进行评估。
结果:得到的平均校正角为32.33°±2.83°。根据MEPI评分评估，21例患者中有19例预后良好，2例预后良好。两名患者抱怨明显的疤痕；然而，没有进行进一步的整容手术.术前运动范围为135.0°,术后为133.7°,没有显着差异(p=0.326)。没有显示神经血管损伤的证据或抱怨肱骨外侧突出。
结论：佩利纠正儿童肘内翻畸形的原则对于治疗这种疾病是有效和可靠的。
方法：治疗IV。
