Isosceles Triangular Osteotomy For Cubitus Varus In Children

Objective The cubitus varus(CV)refers to the normal disappearance of the elbow joint,the rotation of the forearm inward,resulting in changes in the appearance of the elbow and the normal anatomy.At present,there are many methods of treatment cubitus varus,Mainly reflected in the diversity of humeral osteotomy.At present,the main osteotomy of the distal humeral distal wedge osteotomy,trapezoidal osteotomy,arc-shaped osteotomy and so on.Although the advantages of various methods are significant,but there are obvious shortcomings,the most common deficiency were the appearance defects of the lateral bone protrusion after the distal osteotomy,surgical design is complex,and difficult to spread the operation method,for the above deficiencies,We designed the isosceles triangle osteotomy,the method can be a good way to make up for the lack of traditional osteotomy.Therefore,this article will explore the suitability,advantages and disadvantages of application the distal humerus isosceles triangle osteotomy in children with elbow varus.Methods A total of 25 children with varus deformity were diagnosed in our hospital from February 1,2010 to December 31,2013.15 were male and10 were female,the average age was 9.5(5 to 12)years.Surgical methods are the use of distal humerus isosceles triangle osteotomy,internal fixation are fixed Kirschner wire fixation.All children were preoperative ipsilateraland contralateral elbow orthotopic X-ray examination,and measured ipsilateral valgus angle and contralateral to mention the angle,according to the ipsilateral valgus angle and contralateral to mention the angle The angle of the vertebral triangle of the triangular block,so as to design the osteotomy line.Intraoperative are used outside the small incision approach,exposed distal humeral fossa and coronal fossa vertebrae,according to preoperative design of isosceles triangle osteotomy angle and osteotomy line for humeral osteotomy,ulnar cortex without sawing,from to the role of the hinge,the proximal fixation of the proximal humerus,with the aid of the assistant to the outside of the forearm outreach,close the osteotomy and then use the pre-indwelling Kirschner wire for internal fixation,postoperative plaster fixation for 3-4 weeks.Results All the 25 cases were followed up for 6 to 32 months,average of16 months,no incision infection after surgery,3 cases of mild needle infection,no bone healing delay,no ulnar nerve inflammation cases.all children with elbow varus appearance have been corrected,in line with physical,elbow without pain cases,elbow function are excellent.Conclusion The distal tibial triangular wedge osteotomy is a very practical,effective,reliable,safe and simple methods for correcting the varus deformity in children.It can effectively solve the problem of instability of lateral condyle and osteotomy.The method have less complications,postoperative appearance,good function,is a worth promoted surgical method.