Dr. Sandeep Tripathi presented a new technique for correcting cubitus varus, or gunstock deformity of the elbow, using a lateral closing wedge isosceles triangular osteotomy. The technique was performed on 25 patients aged 6-12 with cubitus varus secondary to malunion of a supracondylar fracture. A lateral incision was made, the osteotomy performed, and fixed with K-wires. Most patients had excellent results with a mean carrying angle of 11.7 degrees. Complications included minor infection and scarring, with one revision for displacement. The author concluded the technique is practical, effective, and reliable for correcting cubitus varus.

1. PRESENTER : DR. SANDEEP TRIPATHI
MODERATOR : PROF.SURENDHER KUMAR

2.  To describe a new technique for
correcting post traumatic cubitus
varus using a lateral closing wedge
isosceles triangular osteotomy

3. CUBITUS VARUS:/gunstock elbow
deviation of forearm toward the midline of the
body, and carrying angle decreased
(5 to 15 degree normal)
Most common complication of supracondylar
fracture
It produce cosmetic deformity

4. PATIENT
 Performed in 25 patient(15-male, 10-female)
 Age group: 6 to 12 year
 From may 2010 to april 2013

5.  All patient had cubitus varus secondary to
malunion of a supracondylar fracture
 Deformity persisted > 2 year
 Good function of elbow
 Full range of elbow movement
 Varus angle > 15 degree

7.  4 TO 6 cm longitudinal incision over lateral
distal humerus
 Between brachioradialis and triceps muscles
 Coronoid fossa exposed circuferentially
 Line of osteotomy make
 Osteotomy made
 Preserve the medial cortical hinge
 Fixed with 2 kirschner wire (k-wire)
 Long arm cast applied with elbow flex 90 deg

10.  PATIENT REVIEVED AT:
 4 weeks
 6 weeks
 3 months
 6 months
 12 months
 Every 2 year

11.  23 Patient had excellent result
 2 patient had good result
 Mean post operative carrying angle in the
corrected elbow was 11.7 degree(7 to 18)

12.  One major complication: patient was
removing the pin and displacing the
osteotomy, for which revision surgery done
 3 patient had a pin site infection
 4 patient had a extensive scarring

13.  A lateral isosceles triangular osteotomy and
k-wire fixation is a
 Practical
 Effective
 Reliable
 Safe & simple method
 Excellent cosmesis
 This approach reduced the incidence of post
operative stiffness & ulnar nerve injury

14. DISCUSSION
CUBITUS VARUS:
(extension+internal rotation+varus angulation
Of distal fragment)
is a complication of supracondylar fracture of
humerus in childhood arising as a result:
Inadequate reduction
Loss of reduction during healing
Growth disturbance due to physeal injury

15. Limitation of the technique:
 Can not correct severe internal rotation
deformity