Management of Malunited Supraconylar Humerus Fractures
Journal Title: GJRA-Global Journal For Research Analysis - Year 2015, Vol 4, Issue 5
Abstract
Fractures around the elbow are notorious for malunion so they call for meticulous intraarticular reduction as well as accurate limb alignment. Supracondylar fracture is the most common fracture around elbow in children and cubitus varus is the most common long term complication of these fractures. Supra condylar fractures of the elbow in children, as well as fractures involving the distal part of the humerus may lead to residual elbow deformity if not properly treated by reduction and maintenance of reduction. Cubitus varus (gunstock deformity) represents the most common long term complication of those fractures in children. Although functional impairment is rare, the cosmetic deformity of the elbow is significant. A number of children with severe posttraumatic cubitis varus deformity also have an internal rotation deformity of the distal humerus accompanied by changes in the biomechanics of the elbow.Various corrective osteotomy procedures have been proposed for treatment of cubitus varus . These include medial opening wedge osteotomy, lateral closing wedge osteotomy, lateral closing wedge osteotomy with simultaneous derotation arc osteotomy, pentalateral osteotomy and dome osteotomy. The goals of osteotomy are correction of the coronal, sagittal and rotational deformity. Prevention of elbow stiffness, through firm fixation of the osteotomy site and early use of the joint, is also desirable. Most of these cases present themselves in childhood only. Presentation with cubitus varus deformity at the age of 17 is not so common and so is my case report of a 17 year old male patient who reported with a cubitus varus deformity of 18 degrees due to a malunited supracondylar humerus fracture. He had a history of a fall at the age of 5 while playing for which he went to a local bone setter who treated him conservatively with an above elbow slab.A dome osteotomy supported by a buttress plate was performed.
Authors and Affiliations
Dr Avinash Tolani
Keywords
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