Deformity; Bone Clinical Trial
Official title:
Applying Paley's Principles to Lateral Closing Wedge Osteotomy for Cubitus Varus Deformity in Children
Humeral osteotomy is the most effective method for evident cubitus varus correction in children. Several osteotomy methods and fixation materials have been developed in the past. By applying the principles of deformity correction described by Paley, the investigators describe a novel corrective technique for cubitus varus involving lateral osteotomy using Kirschner wires.
Supracondylar humerus fractures (SHFs) account for approximately 10% of all pediatric
fractures in children. Poorly treated SHFs can lead to the most common cubitus varus
deformity especially in patients treated conservatively. The cosmetic aspect of this
deformity is the main concern of patients, together with reduced remodeling ability.
Inevitably, surgery is the first choice for such patients. Several osteotomy techniques and
fixation materials have been developed in the last several decades. With the advent of
three-dimensional printing techniques and computed tomography reconstruction methods, more
accurate computing designs have been applied in the correction of cubitus varus. These
techniques make the surgery more complex and require the performance of computed tomography
(CT), resulting in high radiation exposure in children. Paley described the principles of
deformity correction that are widely used for the lower limbs. These principles represent an
alternative with easy application without the need of CT, with less occurrence of prominence
and good cosmetic outcome. According to the Paley principles, all the vertex of the
triangular osteotomy should site on the center of rotation of angulation (CORA) line, by
doing this, the gun-butt deformity was corrected perfectly. More importantly, they help to
accurately correct the anatomic axis of the upper limb. According to our knowledge, this is
the first study describes the lateral closing wedge osteotomy for correction cubitus varus
deformity in children by applying Paley's principles and fixation with K-wires.
Taken together, the investigators aimed at verifying the feasibility of Paley's principles
for deformity correction to treat cubitus varus in children.
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