title: Corrective dome osteotomy using the paratricipital (triceps-sparing) approach for cubitus varus deformity in children.
abstract: BACKGROUND
  Dome osteotomy has been described extensively in literature to correct posttraumatic cubitus varus deformity in children. Most case series on dome osteotomy using the posterior triceps-splitting approach report a decreased postoperative range of motion (ROM). We prospectively analyzed the results of dome osteotomy using the soft-tissue preserving paratricipital, (triceps-sparing) approach with respect to correction of deformity and preservation of elbow ROM.
  
  
  METHODS
  During 2006 to 2009, 24 children with cubitus varus deformity after supracondylar humerus fracture were treated with a dome osteotomy using the triceps-sparing approach. The follow-up period varied between 22 and 36 months (average, 27.6 mo). The average interval between injury to surgery was 26.7 months. The average age of the patients was 9.2 years.
  
  
  RESULTS
  The average preoperative carrying angle (humerus-elbow-wrist angle, HEW) was -17.1 degrees (range, -8 to -30 degrees), whereas the average postoperative carrying (humerus-elbow-wrist) angle was +11.7 degrees (range, -12 to +16 degrees) with a mean correction of 28.8 degrees. The average preoperative ROM in the flexion/extension arc was 126.8 degrees and the average postoperative ROM was 132.1 degrees (range, 110 to 140 degrees). The lateral condylar prominence index changed from an average of -9.5% preoperatively to an average of -15.2% postoperatively. Excellent results were seen in 14 patients, whereas 9 had a good outcome.
  
  
  CONCLUSIONS
  Supracondylar humeral dome osteotomy using the paratricipital approach for cubitus varus deformity allows correction of deformity, prevents lateral condylar prominence and avoids loss of elbow motion.
  
  
  METHODS
  IV.
authors.affiliation: Department of Trauma and Orthopaedics, Epsom and St Helier University Hospital NHS Trust, Surrey, UK. bashb02@gmail.com
authors.forename: Samik
authors.initials: S
authors.lastname: Banerjee
authors.forename: Kanchan Kumar
authors.initials: KK
authors.lastname: Sabui
authors.forename: Jayanta
authors.initials: J
authors.lastname: Mondal
authors.forename: Sundeep Jeten
authors.initials: SJ
authors.lastname: Raj
authors.forename: Dilip Kumar
authors.initials: DK
authors.lastname: Pal
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006810:Humeral Fractures / Q000150:complications*; D016916:Joint Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D016896:Treatment Outcome