Cubitus Varus

Excerpt

Elbow injuries are a frequent occurrence in the skeletally immature pediatric population. The metaphysis of the distal humerus is most susceptible to fractures in this population as it is an area of transition from a tubular configuration to a more flattened triangular cross-section. In addition to this anatomical peculiarity, ligamentous laxity in this age group predisposes pediatric patients between the age of 4 and 8 years to supracondylar fractures of the humerus. Typically, malunion of supracondylar fractures often leads to cubitus varus, or "gunstock deformity."

This condition is a triplanar malalignment of the elbow, characterized by varus angulation in the coronal plane, extension in the sagittal plane, and internal rotation in the transverse plane. Although it is frequently regarded as a purely cosmetic problem in children, it occasionally causes late-onset lateral elbow pain, symptomatic elbow posterolateral rotatory instability (PLRI), triceps snapping, progressive ulnar and elbow joint varus, ulnar neuropathy, or rarely, predispose to lateral humeral condyle fractures. For this reason, it may be appropriate to offer surgical treatment in the vast majority of patients with this complaint. Various treatment options proposed include observation, hemiepiphysiodesis and growth alteration, and corrective osteotomy. Corrective osteotomy is the preferred method, as it yields the highest probability for success.