Supracondylar Osteotomies of Posttraumatic Distal Humeral Deformities in Young Adults - Technique and Results

BACKGROUND: Cubitus varus deformity is the most common late complication after distal humeral fractures in children. Typical symptoms are increasing instability especially the posterolateral rotatory instability (POLRI), lateral elbow pain and cosmetic problems. Different ways of correction have been described but a gold standard has not yet been established. METHODS: In this study the clinical outcome 6,5 months after supracondylar closed wedge osteotomy stabilized with locking plates in four young adults was investigated: three with a posttraumatic varus deformity and one with a posttraumatic valgus deformity of the distal humerus. RESULTS: All patients showed good or excellent results in the Mayo Elbow Performance Score (MEPS) and the Disabilities of the Arm, Shoulder and Hand score (DASH). In one case, a revision because of a delayed union was necessary, in another case a preexisting pseudarthrosis of the radial epicondyle remained. Neither a residual instability of the elbow joint, nor any significant prominence of the lateral epicondyle was observed. CONCLUSION: The supracondylar closed wedge osteotomy stabilized by a locking plate is an effective procedure for the correction of posttraumatic distal humerus deformities in young adults with good final functional results.