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The Journal of Bone and Joint Surgery, Vol 72, Issue 5 757-765, Copyright © 1990 by Journal of Bone and Joint Surgery, Inc
Post-traumatic cubitus varus. Long-term follow-up of corrective supracondylar humeral osteotomy in children
E Ippolito, MR Moneta and C D'Arrigo
Department of Orthopedic Surgery, University of Rome La Sapienza, Italy.
The results in twenty-four patients who had had a supracondylar osteotomy
of the humerus to correct post-traumatic cubitus varus were reviewed after
the patients had completed skeletal growth. The average age of the patients
was 7.9 years at operation and thirty-one years at the time of follow-up.
The average duration of follow-up was twenty-three years. According to our
grading system, seven patients had a good; six, a fair; and eleven, a poor
result. All but two of the nineteen patients in whom the humero-ulnar angle
had been measured preoperatively lost correction that had been obtained at
operation. No correlation was found between the quality of the result and
either the age of the patient at operation or the amount of correction that
had been obtained at operation. The correction that was obtained at
operation was maintained in the two patients in whom the cubitus varus
deformity had been caused by malunion of a supracondylar fracture. However,
when the deformity followed either physeal injury or supracondylar fracture
with damage to the physis secondary to the initial trauma, the correction
was not maintained. At the most recent follow-up, three patients were
symptomatic, and fourteen were dissatisfied with the cosmetic result
because of the residual deformity of the elbow or the postoperative scar,
or both. In spite of the partial recurrence of the deformity, which was
sometimes severe, all but the three symptomatic patients had a very good
functional result. Many of these patients worked at heavy manual labor.
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