[Double volume internal fixation for correction of adult post-traumatic cubitus varus deformity].

OBJECTIVE: Supracondylar closing wedge osteotomy is a standard operation for the management of post-traumatic cubitus varus deformity. There are many fixation methods for the broken ends of bone. However, most of these fixation methods are fraught with various complications. To evaluate the methods and functional results of double volume internal fixation for correction of adult post-traumatic cubitus varus deformity.

METHODS: The clinical data were retrospectively reviewed, from 22 cases of adults post-traumatic cubitus varus deformity between June 2007 and December 2010. There were 16 males and 6 females, aged 18-29 years (mean, 21 years) and they all had a history of supracondylar fracture. The deformities of cubitus varus appeared at 6 months (range, 3 months to 1 year) after fracture, and the operations were carried out at 4-17 years (mean, 8 years) after deformity occurrence. The valgus angle were 16-25 degrees (mean, 20.6 degrees) and the Flynn functional scores were all poor before operation. Supracondylar closing wedge osteotomies were performed. Two reconstruction plates were moulded and placed to the media and lateral volumes of the humerus to fix the broken ends of the osteotomy surfaces. External fixation was not needed and early rehabilitation was performed postoperatively in all cases.

RESULTS: Incisions healed by first intention. All cases were followed up 6 to 24 months (mean, 13 months). At last follow-up, the valgus angle was 0-10 degrees (mean, 7.5 degrees). All cases got bone union at 8-13 weeks (mean, 10 weeks) after operation. No related complications occurred, such as infection, nervous or vein injury, and loosening or breakage of internal fixator; and no cubitus varus recurred. The Flynn scores were excellent in 17 cases, good in 3 cases, and fair in 2 cases; the excellent and good rate was 91%.

CONCLUSION: The operation of supracondylar osteotomy with double plates internal fixation for the correction of adult post-traumatic cubitus varus deformity can rigidly stabilize distal humerus, which is helpful to functional training just after operation and satisfactory restoration of the elbow function.