CENK ÖZKAN, Mehmet Ali DEVECİ, MUSTAFA TEKİN, ÖMER SUNKAR BİÇER, Kadir GOKÇE, Mahir GÜLŞEN

Treatment of post-traumatic elbow deformities in children with the Ilizarov distraction osteogenesis technique

Objective: The present study assessed functional and radiographic outcomes of distraction osteogenesistreatment of post-traumatic elbow deformities in children.Methods: Eight children were treated between 2008 and 2013 for post-traumatic elbow deformitiesusing distraction osteogenesis. Mean age at time of operation was 10.9 years. Six patients had varus and 2had valgus deformity. Magnitude of correction,Şxator index, complications, carrying angle, and elbowrange of motion were assessed. Functional results were graded according to protocol of Bellemore et al.Results: Mean follow-up was 43 months. Mean preoperative varus deformity in 6 patients was 29.2andvalgus deformity in 2 patients was 28.5. Preoperativeflexion and extension of elbow were 123.8and 10.6, respectively. Mean carrying angle was 9valgus at last follow-up. Meanflexion andextension were 134.4and 6.0, respectively. Change in carrying angle was statistically signiŞcant(p¼ 0.002). There were 2 grade 1 pin tract infections and 1 diaphyseal fracture of humerus. Functionaloutcome was rated excellent in 7 patients and good in 1 patient.Conclusion: Ilizarov distraction osteogenesis is a valuable alternative in treatment of elbow deformitiesin children. The surgical technique is simple and correction is adjustable. Gradual correction preventspossible neurovascular complications and minimally invasive surgery produces less scarring. Complianceof patient and family is key factor in the success of the outcome.Level of evidence: Level IV, therapeutic study© 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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Piskin A, Tomak Y, Sen C, Tomak L. The management of cubitus varus and valgus using ilizarov method. J Bone Jt Surg Br. 2007;89(12):1615e1619.

Gong HS, Chung MS, Oh JH, Cho HE, Baek GH. Oblique closing wedge osteotomy and lateral plating for cubitus varus in adults. Clin Orthop Relat Res. 2008;466(4):899e906.

Kalacı A, Ozkan C, Yanat AN, EUROney T, Sever G, Do gramacı Y. Two different methods of supracondylar lateral wedge osteotomy in cubitus varus deformity in adults. Eklem Hast Cerrahisi. 2009;20(3):136e142.

Karatosun V, Alekberov C, Alici E, Ardiç CO, Aksu G. Treatment of cubitus varus using the Ilizarov technique of distraction osteogenesis. J Bone Jt Surg Br. 2000;82(7):1030e1033.

Barrett IR, Bellemore MC, Kwon YM. Cosmetic results of supracondylar osteotomy for correction of cubitus varus. J Pediatr Orthop. 1998;18:445e447.

Usui M, Ishii S, Miyano S, Narita H, Kura H. Three-dimensional osteotomy for cubitus varus after supracondylar fracture of the humerus in children. J Pediatr Orthop. 1991;11:327e331.

Wong HK, Lee EH, Balasubramaniam P. The lateral condylar prominence. A complication of supracondylar osteotomy for cubitus varus. J Bone Jt Surg Br. 1990;72:859e861.

Herzenberg JE, Waanders NA. Calculating rate and duration of distraction for deformity correction with the Ilizarov technique. Orthop Clin North Am. 1991;22:601e611.

Bellemore MC, Barrett IR, Middleton RWD, Scougall JS, Whiteway DW. Supra- condylar osteotomy of the humerus for correction of cubitus varus. J Bone Jt Surg Br. 1984;66(4):566e572.

Ozkan C, Do gramacı Y, Kalacı A, Güls¸en M, Bayram H. Results of using Ilizarov distraction osteogenesis technique for the treatment of cubitus varus de- formities in adults. Arch Orthop Trauma Surg. 2010;130(4):489e495.

Song HR, Cho SH, Jeong ST, Park YJ, Koo KH. Supracondylar osteotomy with IlizarovŞxation for elbow deformities in adults. J Bone Jt Surg Br. 1997;79(5): 748e752.

Hernandez 3rd MA, Roach JW. Corrective osteotomy for cubitus varus defor- mity. J Pediatr Orthop. 1994;14:487e491.

Al-Sayyad MJ. Taylor spatial frame in the treatment of upper extremity con- ditions. J Pediatr Orthop. 2012;32(2):169e178.

Kang HJ, Koh IH, Jeong YC, Yoon TH, Choi YR. EfŞcacy of combined osteotomy and ulnar nerve transposition for cubitus valgus with ulnar nerve palsy in adults. Clin Orthop Rel Res. 2013;471:3244e3250.

Ippolito E, Moneta MR, D'Arrigo C. Post-traumatic cubitus varus. Long-term follow-up of corrective supracondylar humeral osteotomy in children. J Bone Jt Surg Am. 1990;72:757e765.

Birch JG, Samchukov ML. Use of the Ilizarov method to correct lower limb deformities in children and adolescents. J Am Acad Orthop Surg. 2004;12: 144e154.