Clinical Outcome of Dome Osteotomy in Cubitus Varus

Cubitus varus or “gunstock” deformity, a common longterm complication of a supracondylar fracture [1]. Components of cubitus varus deformity are: a) medial angulation, b) medial rotation, c) extension of distal fragment with or without d) medial epicondyle epiphyseal injury leading to delayed growth of medial condyle and cubitus varus deformity [2]. It is generally believed that functional impairment is none and it causes only cosmetic deformity of the elbow. Many surgical techniques to correct a cubitus varus deformity are described in literature [3-5]. These include opening wedge, closing wedge and three-dimensional osteotomies and reverse ‘V’ osteotomy [6-12]. Closed wedge osteotomy is easy to perform but it leads to lateral condyle prominence, inadequate removal of wedge and shortening. Medial opening wedge osteotomy is associated with stretching of ulnar nerve and instability and need for bone graft and difficulty in fixation [13].Three dimensional osteotomy is difficult to perform but among all the surgical treatments available, dome osteotomy has the ability to realign the distal fragment in horizontal and coronal plane both. The residual prominence of the lateral condyle and loss of elbow rotation is avoided [8,1415]. Although, dome osteotomy has been described by Tachdjian in 1972, however, there is not enough clinical evidence available. Considering the advantages of dome osteotomy, we did a study and evaluated the results of dome osteotomy.