• Title/Summary/Keyword: Cubitus varus

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Clinical Results of Supracondylar Dome Osteotomy for Cubitus Varus and Valgus Deformities in Adults

  • Gwark, Ji-Yong;Im, Jin-Hyung;Park, Hyung Bin
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.229-236
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    • 2016
  • Background: Cubitus varus and cubitus valgus deformities are common complications of distal humeral fractures in children. We evaluated the usefulness of supracondylar dome osteotomy as a treatment option for adults with cubitus varus or valgus deformity developed during childhood. Methods: Ten patients who had received supracondylar dome osteotomy and stabilization with plates to treat cubitus varus or valgus deformity between July 2006 and August 2013 were included in this study. Their mean age at the time of surgery was $36.50{\pm}10.22years$. The mean follow-up duration was $54.80{\pm}32.50months$. We evaluated humerus-elbow-wrist angles (HEWA), improvements in the lateral prominence index (LPI) or medial prominence index (MPI), Mayo elbow performance scores (MEPS), and overall results in accordance with the Banerjee criteria. Results: For the six patients with cubitus varus, the mean postoperative HEWA, mean correction angle, and mean improvement in LPI were $9.72^{\circ}{\pm}3.95^{\circ}$, $27.67^{\circ}{\pm}10.75^{\circ}$, and $6.92%{\pm}3.40%$, respectively. For the four patients with cubitus valgus, the mean postoperative HEWA, mean correction angle, and mean improvement in MPI were $14.73^{\circ}{\pm}2.97^{\circ}$, $11.55^{\circ}{\pm}3.26^{\circ}$, and $11.33%{\pm}6.39%$, respectively. There was no significant difference between postoperative and preoperative mean MEPS. The subjective ulnar nerve symptoms were alleviated in all patients. The overall results were excellent in six and good in four patients. Conclusions: This study suggests that supracondylar dome osteotomy with secure fixation using double plates may be useful in correcting cubitus varus or cubitus valgus deformity, yielding good functional outcomes in adults.

Three-Dimensional Corrective Osteotomy for Treatment of Cubitus Varus after Supracondylar Fracture of the Humerus (상완골 과상부 골절후 발생한 내반주 변형에 대한 삼차원 교정 절골술)

  • Kim Poong Taek;Ihn Joo Chul;Kyung Hee Soo;Oh Seung Hoon
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.58-65
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    • 1998
  • Cubitus varus deformity after supracondylar fracture of the humerus in children generally includes deformities of varus, hyperextension and internal rotation. Recently almost all corrective osteotomies for treatment of the varus deformity have been limited to correction of only the varus or of the varus and hyperextension deformity. Electromyographic study has revealed unphysiological joint motion and muscle activity around the joint in elbows with cubitus varus, hyperextension and internal rotation deformity. On this basis we have successfully attempted simultaneous correction of all three deformities. The end results in ] 3 elbows have been satisfactory without any complications such as delayed union, limitation of elbow motion or nerve palsy. In conclusion, we recommend simultaneous correction of the three elements of cubitus varus deformity to restore anatomic alignment of the elbow joint.

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New Fixation Method Using Two Crossing Screws and Locking Plate for Cubitus Varus Deformity in Young Adult Elbow: Case Report

  • Kim, Byoung Jin;Seol, Jong Hwan;Kim, Myung Sun
    • Clinics in Shoulder and Elbow
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    • v.19 no.1
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    • pp.43-47
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    • 2016
  • Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months followup, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.

Tardy Ulnar Nerve Palsy Caused by Bilateral Cubitus Varus Deformities - A Case Report - (양측성 내반주 변형에 동반된 지연성 척골 신경 마비(1례 보고))

  • Lee Sang Yup;Kim Jeong Hwan;Lee Sang Gug;Chung Chae Ik;Kim Young Hwan;Hwang Sik
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.209-213
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    • 1999
  • It is well known that tardy ulnar nerve palsy occurs with cubitus valgus deformity as a late complication after a nonunion of lateral condyle fracture of the humerus in childhood. On the other hand, cubitus varus deformity often results from malunion of supracondylar fractures of the humerus. However, reports of tardy ulnar nerve palsy in cubitus varus deformity are few. We report a patient with bilateral cubitus varus deformities with bilateral tardy ulnar nerve palsy which was confirmed with EMG. She was treated by step cut osteotomy(DeRosa and Graziano) with sub­cutaneous anterior transposition of ulnar nerve.

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Tardy Ulnar Nerve Palsy due to Cubitus Varus Deformity (내반주 변형에 의한 지연성 척골 신경 마비)

  • Jeon, In-Ho;Kim, Poong-Taek;Park, Byung-Chul;Ihn, Joo-Chul
    • Clinics in Shoulder and Elbow
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    • v.5 no.1
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    • pp.29-36
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    • 2002
  • Purpose : Cubitus varus deformity has been reported to cause ulnar neuropathy. We present five cases of tardy ulnar nerve palsy due to cubitus vus and analyzed the factors related to the nerve plasy caused by the deformity. Materials and Methods : Three men and two women were reviewed retrospectively and the mean age of the patients were 26 (range, 14-38). The average interval from initial fracture to nerve palsy was 19 years (8-32 years). The severity of symptoms, according to McGowan's classification, was grade I of 2 patients, grade Ⅱ of 3 patients. Carrying angle was an average of 18。 (30° -45° ). Internal rotation angle measured by Yamamoto's method was an average of 33° (30° -45° ). Results ㆍ The mean follow-up period was 53 months (35-70 months). Elbow pain and numbness of the fingers were relieved shortly after surgery. It revealed that anterior subluxation of the nerve due to internal rotation deformity and compression of the nerve between the medially shifted medial head of triceps and the medial epicondyle. Conclusion : The major entrapment point of the nerve is the fibrous band between the two heads of the flexor carpi ulnaris. The severe internal rotation deformity may contribute the cause of tardy ulnar nerve palsy in cubitus varus deformity.

In vivo 3-dimensional Kinematics of Cubitus Valgus after Non-united Lateral Humeral Condyle Fracture

  • Kim, Eugene;Park, Se-Jin;Lee, Ho-Seok;Park, Jai-Hyung;Park, Jong Kuen;Ha, Sang Hoon;Murase, Tsuyoshi;Sugamoto, Kazuomi
    • Clinics in Shoulder and Elbow
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    • v.21 no.3
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    • pp.151-157
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    • 2018
  • Background: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. Methods: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, $90^{\circ}$ flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. Results: Ulno-humeral joint moved to the varus on the coronal plane during flexion, $25.45^{\circ}$ in the non-united cubitus valgus group and $-2.03^{\circ}$ in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane $-26.75^{\circ}$ in the non-united cubitus valgus group and $-3.09^{\circ}$ in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. Conclusions: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.

A Study about the Type of Cubits.Genu Angle and the Distance of both Knee Joint in General (정상인의 팔굽, 무릎관절의 형태와 내.외반의 각도 및 무릅관절 간의 길이에 대한 조사)

  • Kim, Keun-Jo;Lee, Cu-Ri;Cheon, Jae-Kyun
    • Journal of Korean Physical Therapy Science
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    • v.1 no.2
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    • pp.289-299
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    • 1994
  • This study was researched the general characteristics, the elbow-knee joint form, the varus and valgus angle and the both knee joint distance of the 215 persons form July 1, 1994 to July 15, 1994. The results were as follows : 1. The form of elbow joint was significant statistically in the sex group(p<0.05). 2. The angle of elbow joint was very significant statistically in the age group and sex. B.M.I. group(p<0.001, p<0.01, p<0.01), and the average angle was $9^{\circ}.51{\pm}4^{\circ}.79$(n=215). 3. The angle of Cubitus valgus was very significant statistically in the age group(p<0.001), and the average angle of Cubitus valgus was $10^{\circ}.85{\pm}3^{\circ}.76$(n=187). 4. The angle of Knee joint was significant statistically in the age group(p<0.05), and the its average angle was $7^{\circ}.63{\pm}4^{\circ}.52$(n=215). 5. The angle of Genu varus was significant statistically in the age and sex group(p<0.05, p<0.05), and the its average was $6^{\circ}.92{\pm}2^{\circ}.36$(n=27). 6. The angle of Genu valgus was very significant statistically in the age group(p<0.001), and the its average angle was $9^{\circ}.75{\pm}2^{\circ}.94$(n=149). 7. The distance of both Knee joint was significant statistically in the age group and B. M. I. group (p<0.001, p<0.05), and the its average distance was $2.55{\pm}1.45cm$(n=135).

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