Medial Approach for Corrective Osteotomy of Cubitus Varus

Osteotomies described previously to correct cubitus varus had been associated with unsatisfactory results such as a prominent lateral scar and condyle and injury to the triceps. The authors evaluated the results of a medial approach for the corrective osteotomy of 14 consecutive children (mean age 8.4 years) with cubitus varus. The incision was made medially and the ulnar nerve was identified and protected. An image intensifier was used to identify the wedge. Lateral closing wedge osteotomy was performed and secured with cross K-wires, and the distal fragment was translated medially to reduce the lateral prominence. Both hyperextension and internal rotation deformity could be corrected with the osteotomy. The mean carrying angle and hyperextension of the elbow of 19.3° varus and 22.2° were corrected to 2.4° valgus and 8.8° respectively. Radiographically, the Baumann's angle and the flexion angle were improved from 90.1° to 77.3° and 24.2° to 37.2° respectively. No patient had a prominent lateral condyle, and the operative scars were well concealed along the medial aspect of the elbow. There was one case of transient ulnar nerve paresis with residual varus.