PDF(Pubmed)
Abstract：
BACKGROUND: Cubitus varus deformity is a complex 3-dimensional deformity. Various osteotomies have been introduced to correct this deformity, however, there is no consensus on the best procedure to correct the deformity while avoiding complications. In this retrospective study, we used a modified inverse right-angled triangle osteotomy to treat 22 children with posttraumatic cubitus varus deformity. The primary objective was to evaluate this technique by presenting its clinical and radiologic results.
METHODS: Twenty-two consecutive patients with a cubitus varus deformity underwent a modified reverse right-angled triangle osteotomy between October 2017 and May 2020 and were then followed for a minimum of 24 months. We evaluated its clinical and radiologic results. Functional outcomes were assessed using Oppenheim criteria.
RESULTS: The average follow-up period was 34.6 months (range, 24.0 to 58.1 months). The mean range of motion was 4.32 degrees (range, 0 degrees to 15 degrees)/122.73 degrees (range, 115 degrees to 130 degrees) (hyperextension/flexion) before surgery and 2.05 degrees (range, 0 degrees to 10 degrees)/127.27 degrees (range, 120 degrees to 145 degrees) at the final follow-up. There were significant ( P < 0.05) differences between the flexion and hyperextension angles before surgery and at the final follow-up. Based on Oppenheim criteria, results were excellent for 20, good for 2, and none of the patients had poor results. The mean humerus-elbow-wrist angle improved from 18.23 degrees (range, 10 degrees to 25 degrees) varus preoperatively to 8.45 degrees (range, 5 degrees to 15 degrees) valgus postoperatively ( P < 0.05). The mean of the preoperative lateral condylar prominence index was 3.52 (range, 2.5 to 5.2) and the average postoperative lateral condylar prominence index was -3.28 (range, -1.3 to -6.0). All patients were pleased with the overall appearance of their elbows.
CONCLUSIONS: The modified reverse right-angled triangle osteotomy can precisely and stably correct the deformity in the coronal and sagittal planes, we recommend this technique as a simple, safe, and reliable correction of cubitus varus deformity.
METHODS: Level IV; case series; therapeutic studies-investigating the results of treatment.
METHODS: Twenty-two consecutive patients with a cubitus varus deformity underwent a modified reverse right-angled triangle osteotomy between October 2017 and May 2020 and were then followed for a minimum of 24 months. We evaluated its clinical and radiologic results. Functional outcomes were assessed using Oppenheim criteria.
RESULTS: The average follow-up period was 34.6 months (range, 24.0 to 58.1 months). The mean range of motion was 4.32 degrees (range, 0 degrees to 15 degrees)/122.73 degrees (range, 115 degrees to 130 degrees) (hyperextension/flexion) before surgery and 2.05 degrees (range, 0 degrees to 10 degrees)/127.27 degrees (range, 120 degrees to 145 degrees) at the final follow-up. There were significant ( P < 0.05) differences between the flexion and hyperextension angles before surgery and at the final follow-up. Based on Oppenheim criteria, results were excellent for 20, good for 2, and none of the patients had poor results. The mean humerus-elbow-wrist angle improved from 18.23 degrees (range, 10 degrees to 25 degrees) varus preoperatively to 8.45 degrees (range, 5 degrees to 15 degrees) valgus postoperatively ( P < 0.05). The mean of the preoperative lateral condylar prominence index was 3.52 (range, 2.5 to 5.2) and the average postoperative lateral condylar prominence index was -3.28 (range, -1.3 to -6.0). All patients were pleased with the overall appearance of their elbows.
CONCLUSIONS: The modified reverse right-angled triangle osteotomy can precisely and stably correct the deformity in the coronal and sagittal planes, we recommend this technique as a simple, safe, and reliable correction of cubitus varus deformity.
METHODS: Level IV; case series; therapeutic studies-investigating the results of treatment.
摘要：
背景：肘内翻畸形是一种复杂的3维畸形。已经引入了各种截骨术来纠正这种畸形，然而,对于矫正畸形同时避免并发症的最佳方法尚无共识。在这项回顾性研究中,我们使用改良的逆直角三角形截骨术治疗了22例儿童创伤后肘内翻畸形。主要目的是通过介绍其临床和放射学结果来评估该技术。
方法：在2017年10月至2020年5月期间，连续22例肘内翻畸形患者接受了改良的反向直角三角形截骨术，然后随访至少24个月。我们评估了其临床和放射学结果。使用Oppenheim标准评估功能结果。
结果：平均随访时间为34.6个月（范围，24.0至58.1个月）。平均运动范围为4.32度（范围，0度至15度)/122.73度(范围，115度至130度）（过度伸展/屈曲）术前和2.05度（范围，0度至10度）/127.27度（范围，120度到145度)在最后的随访。术前和末次随访时，屈伸和过伸角之间存在显着差异（P<0.05）。根据奥本海姆标准,结果为20例优异，2例良好，没有患者效果不佳。平均肱骨-肘部-腕部角度从18.23度改善（范围，10度至25度）术前内翻至8.45度（范围，5度至15度)术后外翻(P<0.05)。术前外侧髁突突出指数平均值为3.52(range,2.5至5.2），术后平均外侧髁突突出指数为-3.28（范围，-1.3至-6.0）。所有患者都对肘部的整体外观感到满意。
结论：改良的反向直角三角形截骨术可以精确稳定地矫正冠状面和矢状面的畸形，我们推荐这种技术作为一个简单的，安全,可靠矫正肘内翻畸形。
方法：IV级；病例系列；治疗性研究-研究治疗结果。
方法：在2017年10月至2020年5月期间，连续22例肘内翻畸形患者接受了改良的反向直角三角形截骨术，然后随访至少24个月。我们评估了其临床和放射学结果。使用Oppenheim标准评估功能结果。
结果：平均随访时间为34.6个月（范围，24.0至58.1个月）。平均运动范围为4.32度（范围，0度至15度)/122.73度(范围，115度至130度）（过度伸展/屈曲）术前和2.05度（范围，0度至10度）/127.27度（范围，120度到145度)在最后的随访。术前和末次随访时，屈伸和过伸角之间存在显着差异（P<0.05）。根据奥本海姆标准,结果为20例优异，2例良好，没有患者效果不佳。平均肱骨-肘部-腕部角度从18.23度改善（范围，10度至25度）术前内翻至8.45度（范围，5度至15度)术后外翻(P<0.05)。术前外侧髁突突出指数平均值为3.52(range,2.5至5.2），术后平均外侧髁突突出指数为-3.28（范围，-1.3至-6.0）。所有患者都对肘部的整体外观感到满意。
结论：改良的反向直角三角形截骨术可以精确稳定地矫正冠状面和矢状面的畸形，我们推荐这种技术作为一个简单的，安全,可靠矫正肘内翻畸形。
方法：IV级；病例系列；治疗性研究-研究治疗结果。
