Cubitus varus

Cubitus varus or Gunstock deformity correction

This deformity develops after trauma to elbow. Most common cause is a malunited supracondylar fracture followed by lateral or medial condyle fracture. Post traumatic growth arrest can also cause this deformity.  Patient usually present with a cosmetic problem. Some may also complain of progression of deformity, pain, instability. They are also prone for Lateral condyle humerus fracture.

7 yrs old girl with deformity on gunstock deformity on right side

Immediate postoperative long cast

Postoperative correction after6 weeks

Progressive cubitus varus due to posttraumatic medial arrest

Distal cut marked with kwire just proximal to olecronon parallel the joint line

Proximal wire passed to meet distal one just short of medial border, note the angle between the wires is the desired correction measured preop

Distal most wire from lateral condyle,  prepared for stabilizing ostetotomy after cuts are taken. Note proximally screw with washer for tension band wiring.

  

Initially cuts are made along the wires with an oscillating small saw but medial cortex left intact. Note the osteotome in distal cut and kwire ready for insertion distally

Intraop correction and fixation

Postoperative xrays after 6 weeks : good correction achieved

Helping kids improve cosmetically.....

Foot drop

Foot Drop

A condition where foot fails to dorsiflex during swing phase. Here is a case of a 6 year old child with footdrop. He has a postinjection palsy. The photos and videos are descriptive of the initial presentation and treatment that followed. Tibialis posterior was transferred to lateral cuneiform.

 

Right high stepping gait to get adequate clearance from ground.

Exposure of insertion of tibialis posterior, tendon harvested and secured with ethibond

Proximal posteriomedial incision for retrieving tendon, passed through interosseous memberane from posterior to anterior.

 

Tendon retrieved through anterior incision

Lateral cuneiform identified under Carm

Exposure of lateral cunieform

Entry made and tendon secured through cunieform using suture anchor button at bottom of sole.

 

Postoperative good functional transfer : 3 months postop

 

Gait improvement noticed 6 months postop

 Helping kids improve functionally..... 

BOW LEGS KNOCK KNEES

1) Physiological bow legs in 18 months old child

Observation and followup is needed upto 2years

2) Infantile Blount's disease in 4 yrs old child, note the abrupt bending on the left side

3) Left genu varum In 10 yrs old boy due to medial physeal arrest distal femur