Evaluating Outcomes of Step-Cut Osteotomy for Pediatric Cubitus Deformities

Introduction: Supracondylar fractures in children often result in malunion and subsequent cubitus varus or valgus deformity. While often considered cosmetic, these deformities can lead to pain, functional impairment, and other complications. Corrective osteotomy is a common treatment option, with step-cut osteotomy being a preferred method due to its effectiveness and relative simplicity. This study aims to evaluate the outcomes of step-cut osteotomy in correcting post-traumatic cubitus deformities.

Materials and methods: A prospective cohort study was conducted on patients presenting with post-traumatic cubitus varus or valgus deformity. Pre-operative evaluation included clinical and radiological assessment of the deformity. Step-cut osteotomy was performed, followed by rigid fixation with a recon plate. Post-operative outcomes were assessed in terms of deformity correction, range of motion (ROM), and complications.

Results: The study included 10 patients (8 male, 2 female) with a mean age of 9.6 years. The mean pre-operative carrying angle was 25.25° varus, corrected to 3.37° valgus postoperatively. Significant improvement in ROM and humerus-elbow-wrist angle was observed. While the lateral prominence index decreased, it was not statistically significant. Excellent or good results were achieved in 80% of patients. One patient experienced transient radial nerve palsy.

Discussion: Step-cut osteotomy effectively corrected cubitus deformities with minimal complications. While it primarily addresses coronal plane deformity, satisfactory outcomes were achieved without correction of rotational deformity. Rigid fixation with a recon plate provided stability and allowed for early mobilization. The study's limitations include a small sample size and the inability to conduct adequate follow-up due to the COVID-19 pandemic.

Conclusion: Step-cut osteotomy is a reliable and effective treatment option for post-traumatic cubitus varus and valgus deformities in children. It demonstrates good to excellent outcomes in terms of deformity correction, ROM, and functional improvement, with a low complication rate. Further studies with larger sample sizes and longer follow-up periods are warranted to strengthen these findings.