title: A Simple Dual-Planar Osteotomy to Correct Cubitus Varus Deformity in Children.
abstract: OBJECTIVE
  To report the outcomes when performing a dual-planar osteotomy of the distal humerus via a posterior approach for gunstock deformity in children.
  
  
  METHODS
  A retrospective review.
  
  
  METHODS
  Penn State Hershey Pediatric Bone and Joint Institute.
  
  
  METHODS
  Sixteen patients were reviewed. The average patient age was 8 years (range, 5-13 years).
  
  
  METHODS
  A complete dual-planar closing wedge osteotomy was performed with the patient in the prone position via a posterior triceps-splitting approach. Fixation with buried smooth K wires was utilized.
  
  
  METHODS
  Valgus correction obtained, final elbow range of motion, radiographic and clinical correction of the deformity, the patient's satisfaction, and elbow function were evaluated.
  
  
  RESULTS
  Preoperative radiographs showed the average humeral-ulnar angle (HUA) was 17 degrees of varus (range, 10-26 degrees varus). The average wedge removed wallow-up clinical exam demonstrated that the carrying angle was in valgus in 15 cases and neutral in 1 case. The average carrying angle was 5 degrees of valgus (range, 0-11 degrees valgus). The average hyperextenss 25 degrees (range, 20-40 degrees). Duration of follow-up averaged 51 months (range, 12-126 months). Final foion deformity improved from 9 degrees preoperatively to 1 degree postoperatively. Outcomes were classified by the grading scale described by Oppenheim: 14 cases had excellent results and 2 cases had good results.
  
  
  CONCLUSIONS
  This method provides clear visualization and excellent correction of the deformities. The posterior scar is cosmetically acceptable. We recommend this technique for the treatment of gunstock deformity in children.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *CORE Orthopaedics, Avera Medical Group, Sioux Falls, SD; and †Department of Orthopaedics and Rehabilitation, The Pennsylvania State University College of Medicine, Hershey, PA.
authors.forename: Travis R
authors.initials: TR
authors.lastname: Liddell
authors.forename: William L
authors.initials: WL
authors.lastname: Hennrikus
authors.forename: James J
authors.initials: JJ
authors.lastname: Bresnahan
mesh_terms: D000293:Adolescent; D002648:Child; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000150:complications / Q000601:surgery*; D006811:Humerus / Q000293:injuries / Q000601:surgery*; D016916:Joint Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D008297:Male; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D000092464:Elbow Injuries