Thursday 23 January 2014

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.....

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