French osteotomy for cubitus varus in children: a long term study over 27 years
Background: Cubitus varus is a cosmetically unacceptable complication of supracondylar fractures of the elbow in children. We have performed the lateral closing wedge (French) osteotomy to correct the varus for 27 years. More complex osteotomies have been described to correct the associated hyperextension and internal rotation deformities and to prevent a prominent lateral condyle. Methods: We retrospectively reviewed 90 consecutive patients (1986-2012). The mean age of the patients at surgery was 8.2 years (3 to14 years). The varus angle (mean 21.4°, range 8°- 40°) was assessed pre-operatively with the humero-elbow-wrist (HEW) angle. The postoperative carrying angle (mean 10.4) and the pre- and postoperative range of movement were assessed clinically. The lateral condylar prominence index (LCPI) was retrospectively measured at union. Results: Seventy five (93.3%) of the patients had a good or excellent result. Six (6.7%) had a poor result (residual varus, loss of >20°of pre-operative range of flexion or extension or a complication necessitating repeat surgery). There were no neuro-vascular complications. The mean LCPI was +0.14. Conclusions: The results of the French osteotomy are comparable to the more technically demanding dome, step-cut translation and multi-planar osteotomies, with a lower complication rate. The literature reports adequate remodelling of the hyperextension deformity ( ≤ 10 years) patient. Level of evidence: Level IV: Case series
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Department of Health and Rehabilitation Sciences