Oblique closing wedge osteotomy and lateral plating for cubitus varus in adults

Abstract

Corrective osteotomy around the elbow can require longer recovery time in adults than in children because of the longer healing period and the propensity for stiffness. We hypothesized a lateral oblique closing wedge osteotomy with a larger contact area and fixation with a lag screw plus early motion would provide stable fixation and early motion recovery in adults with cubitus varus deformity. Twelve consecutive patients who needed surgery were treated using this procedure. They were allowed active motion exercises 1 week postoperatively. The age of the patients at the time of surgery averaged 39 years (range, 31-48 years). The minimum followup was 15 months. All patients achieved healing of the osteotomy, and regained preoperative arcs of elbow motion at a mean of 7.3 weeks (range, 2-12 weeks) postoperatively. The average humerus-elbow-wrist angle improved from -23.3 degrees to 8 degrees (p < 0.002) by a mean gain of 29.6 degrees . The mean lateral prominence index did not increase postoperatively. The final MEPI and DASH score averaged 95.4 points and 5.5 points. No patient experienced nerve palsy. Oblique osteotomy and fixation with a lag screw and lateral plating is a reasonable alternative technique for cubitus varus in adults, with early recovery of elbow motion and satisfactory deformity correction. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.