Research Articles

Modified French Osteotomy for Cubitus Varus Correction: Our Experience

Abstract

Background: Various fixation techniques have been described for osteotomy for correction of cubitus varus. Kirschner-wiring (K-wiring) was used in the past for fixation; however, rates of fixation failure and pin-track infection were high. Fixation with two screws and a figure-of-eight wiring provides a stable fixation in children younger than 15 years. Herein, we used a modified lateral approach and a figure-of-eight construct with two screws and evaluated the outcome.

 

Methods: A case series comprising 35 patients out of the total of 54 patients who underwent modified French osteotomy between January 2013 to December 2021 was conducted retrospectively. Functional outcomes were assessed using the modified Mayo Elbow Performance Scoring (MEPS) system.

 

Results: There were 22 male and 13 female subjects in the study group. We had excellent results in 16 cases, good outcomes in 13 cases, and fair outcomes in 6 cases. Superficial infection was seen in three patients and four patients had occasional negligible pain. In addition, there was no loss of correction or fixation failures in our study.

 

Conclusion: Modified French osteotomy using two screws and figure-of-eight wiring is a simple and safe procedure that yields satisfactory outcomes. A careful preoperative planning, sufficient surgical technique, and stable fixation are key to achieving satisfactory functional outcomes.

1. Abzug JM, Herman MJ. Management of supracondylar humerus fractures in children: Current concepts. J Am Acad Orthop Surg. 2012;20(2):69-77. doi: 10.5435/JAAOS-20-02-069. [PubMed: 22302444].

2. Wong HK, Lee EH, Balasubramaniam P. The lateral condylar prominence. A complication of supracondylar osteotomy for cubitus varus. J Bone Joint Surg Br. 1990;72(5):859-61. doi: 10.1302/0301-620X.72B5.2211772. [PubMed: 2211772].

3. Hedayat E, Nicolas A, Mohammadi MA, Nabian MH. Step by step approach to interpretation of pediatric elbow radiography. J Orthop Spine Trauma. 2020;5(1):7-11. doi: 10.18502/jost.v5i1.3352.

4. Ippolito E, Moneta MR, D'Arrigo C. Post-traumatic cubitus varus. Long-term follow-up of corrective supracondylar humeral osteotomy in children. J Bone Joint Surg Am. 1990;72(5):757-65. [PubMed: 2355039].

5. Orbach H, Rozen N, Rubin G, Dujovny E, Bor N. Outcomes of French's corrective osteotomy of the humerus for cubitus varus deformity in children. Isr Med Assoc J. 2018;20(7):442-5. [PubMed: 30109795].

6. Solfelt DA, Hill BW, Anderson CP, Cole PA. Supracondylar osteotomy for the treatment of cubitus varus in children: A systematic review. Bone Joint J. 2014;96-B(5):691-700. doi: 10.1302/0301-620X.96B5.32296. [PubMed: 24788507].

7. Uchida Y, Ogata K, Sugioka Y. A new three-dimensional osteotomy for cubitus varus deformity after supracondylar fracture of the humerus in children. J Pediatr Orthop. 1991;11(3):327-31. [PubMed: 2056080].

8. Morrey B, An K, Chao E. Functional evaluation of the elbow. In: Morrey BF, Sanchez Sotelo J, Morrey ME, editors. The elbow and its disorders. 2nd ed. Philadelphia, PA: Saunders; 1993. p. 95.
9. Piggot J, Graham HK, McCoy GF. Supracondylar fractures of the humerus in children. Treatment by straight lateral traction. J Bone Joint Surg Br. 1986;68(4):577-83. doi: 10.1302/0301-620X.68B4.3733834. [PubMed: 3733834].

10. Kumar K, Sharma VK, Sharma R, Maffulli N. Correction of cubitus varus by French or dome osteotomy: A comparative study. J Trauma. 2000;49(4):717-21. doi: 10.1097/00005373-200010000-00021. [PubMed: 11038091].

11. Rang M. Children's fractures. Philadelphia, PA: Lippincott Williams and Wilkins; 1974.

12. Srivastava AK, Srivastava D, Gaur S. Lateral closed wedge osteotomy for cubitus varus deformity. Indian J Orthop. 2008;42(4):466-70. doi: 10.4103/0019-5413.43397. [PubMed: 19753237]. [PubMed Central: PMC2740347].

13. Oppenheim WL, Clader TJ, Smith C, Bayer M. Supracondylar humeral osteotomy for traumatic childhood cubitus varus deformity. Clin Orthop Relat Res. 1984;(188):34-9. [PubMed: 6467726].

14. Song HR, Cho SH, Jeong ST, Park YJ, Koo KH. Supracondylar osteotomy with Ilizarov fixation for elbow deformities in adults. J Bone Joint Surg Br. 1997;79(5):748-52. doi: 10.1302/0301-620x.79b5.7615. [PubMed: 9331029].

15. Raney EM, Thielen Z, Gregory S, Sobralske M. Complications of supracondylar osteotomies for cubitus varus. J Pediatr Orthop. 2012;32(3):232-40. doi: 10.1097/BPO.0b013e3182471d3f.

[PubMed: 22411326].

16. Sweeney JG. Osteotomy of the humerus for malunion of supracondylar fractures. J Bone Joint Surg Br. 1975;57:117.

17. Muller ME, Allgower M, Schneider R, Willenegger H. Manual of internal fixation: Techniques Recommended by the Ao-Asif Group. 3rd ed. Berlin, Germany: Springer Berlin, Heidelberg; 1991.
Files
IssueVol 9 No 4 (2023) QRcode
SectionResearch Articles
DOI https://doi.org/10.18502/jost.v9i4.13935
Keywords
Osteotomy Humerus Fracture Elbow Injuries Fracture Malunion Fracture Fixation
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Madhuchandra P, Pawankumar K, Santhosh GS. Modified French Osteotomy for Cubitus Varus Correction: Our Experience. J Orthop Spine Trauma. 2023;9(4):180-4.