Reverse V Osteotomy of the Distal Humerus for the Correction of Cubitus Varus

Author(s): Mohammad Shahin Akter, Mst. Maksuda Khatun, Abul Hasan, Shahidul Islam, Mohammed Salim Miah, Md. Azizur Rahman

Introduction: Cubitus varus deformity is triplanar, consisting of sagittal, coronal, and rotational components. There are numerous osteotomy techniques proposed in the past to address the correction of this deformity. Most osteotomies are aimed at correcting varus components only and are labelled as uniplanar osteotomies. The goal of the osteotomy is to correct the alignment of the elbow joint to a normal range of 5 to 15 degrees and create a stable joint. Cubitus varus deformity in children is a late complication of supracondylar humerus fracture.

Aim: The study aimed to correct the elbow so that it was anatomically and functionally identical to the opposite normal side. Methods: It is an observational study; 14 children were treated for cubitus varus using a reverse V osteotomy. The study children were treated from January 2021 to December 2021 at Faridpur Medical College and Hospital, Faridpur, Bangladesh. A total of 14 patients had sustained a supracondylar humeral fracture, two lateral condylar fractures, two medial condylar fractures, and one trans-physical separation. All 14 children were treated for cubitus varus using a reverse V osteotomy.

Result: Among the majority, about sixty percent of children were from the age range of 1-2 years. We used Oppenheim’s (1989) grading system to grade our results. This grading system has four labelled (Excellent, Good, Fair, and Poo) which are based on carrying angle (Degree) and range of movement (Degree) Table 1. Table 2 shows the assessment of the results according to modified Oppenheim’s grading system. According to our study, 11(78.57%) children had an excellent outcome without complications, and 3(21.43%) children had a good result without complications.

Conclusion: We recommend this technique as a safe, reliable, reproducible, and technically easy procedure for the correction of cubitus varus deformity.