Background: Many types of osteotomy have been proposed for the
treatment of cubitus varus and valgus, but they have limitations, such as poor
internal fixation, residual protrusion of the lateral or medial condyle,
technical difficulty, the need for long-term immobilization, a risk of
neurovascular injury, and patient discomfort. We reviewed the results of a
simple step-cut translation osteotomy that overcomes these limitations.
Methods: Between 1993 and 2002, we treated nineteen cases of cubitus
varus and thirteen cases of cubitus valgus with use of a simple step-cut
translation osteotomy and fixation with a Y-shaped humeral plate. After
surgery, the patients were observed closely for more than one year. We
compared preoperative and postoperative humerus-elbow-wrist angles, ranges of
motion, and lateral or medial prominence indices for all patients. The results
were evaluated according to the modified criteria of Oppenheim et al. The
presence of tardy ulnar nerve palsy and its duration, and postoperative lazy-s
deformity or unsightly scarring, were also noted.
Results: There were twenty-six excellent and six good results. In
the nineteen patients with cubitus varus, the average amount of correction of
the humerus-elbow-wrist angle was 26.0°, to a mean postoperative angle of
8.6°, and the average increase in the lateral prominence index was 8.2%.
In the thirteen patients with cubitus valgus, the average correction in the
humerus-elbow-wrist angle was 27.6°, resulting in a final angle of
9.1°, and the average increase in the medial prominence index was 11.9%.
In all patients, the desired range of motion, good alignment, and complete
union of the bone were achieved.
Conclusions: Step-cut translation osteotomy, with a wedge-shaped
osteotomized surface, fixed with a Y-shaped humeral plate is a relatively
simple procedure resulting in very firm fixation that allows early movement of
the joint with good clinical results.
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.