Trapezoidal Osteotomy In The Treatment Of Nonunion Of Humeral Lateral Condyle Fractures Complicating Cubitus Valgus Deformity In Children

Objective: To explore the clinical effect of using trapezoidal osteotomy to treat children's nonunion of humeral lateral condyle fractures complicating cubitus valgus deformity.Methods: Retrospectively analyzed 6 cases with nonunion of humeral lateral condyle fractures and cubitus valgus deformity from February 2015 to September 2018 using supracondylar medial trapezoidal osteotomy,following up the union of osteotomy site and nonunion site,the recovery of carrying angle and the function of elbow.Results: All the 6 cases were followed up for 6.2 to 36.3 months(average 20.1 months).All the incisions of the 6 patients were primary healing,no Kirschner wire broken and myositis ossificans happened.The average post-operative carrying angle of the affected side was 5.5±1.6 degrees,and the mean post-operative elbow range of motion(ROM)was 111.7±4.1 degrees,both of them were improved evidently and found statistically significant(P<0.05).The mean pre-operative Mayo elbow performance score(MEPS)was 56.7±13.3 and post-operative was 89.2±8.6,the difference was found to be statistically significant(P<0.05),Rating based on MEPS,2 cases had excellent score,and 4 had good score.The osteotomy site united in 61.3±17.2 days,whereas the nonunion site united in 94.7±27.0 days.2 children had ulnar neuritis before surgery,and postoperative pain in the elbow on the affected side and numbness in the ulnar nerve innervation area disappeared.Among them,the ring finger and little finger on the affected side still could not be fully straightened,however,the symptoms and signs improved significantly compared with before surgery,which did not affect the quality of life.Conclusion: Trapezoidal osteotomy of the humerus is a simple,feasible and effective way to treat nonunion of humeral lateral condyle fractures complicating cubitus valgus deformity in children.