Dome corrective osteotomy for cubitus varus deformity

Between 1994 and 1998, 15 patients had corrective dome-shaped osteotomy of the humerus for posttraumatic cubitus varus deformity. Thirteen patients ha d surgery before puberty and two patients had surgery after puberty, In the prepuberty group, all the osteotomies were done by a posterior approach wi th triceps muscle splitting, and cross pins were used to fix the osteotomy. In the postpuberty group, the osteotomies were done by a posterior approac h with olecranon osteotomy, and reconstructive plates were used for fixatio n. The average followup was 2 years and 4 months. Preoperative carrying ang le ranged from 19 degrees to 31 degrees varus (average, 26.2 degrees) and p ostoperative carrying angle ranged from 7 degrees to 15 degrees valgus (ave rage, 10.7 degrees). No loss of correction was observed and all osteotomies united. The preoperative and postoperative differences of the lateral cond ylar prominence index ranged from -67% to +6% (average, -30.1%). After revi ewing these cases, a dome-shaped osteotomy was found to have the following advantages for correction of cubitus varus deformity: the osteotomy site is more stable than a lateral closing wedge osteotomy for maintaining the cor rection obtained; the domed osteotomy avoids having the lateral condyle bec oming prominent; and the posterior scar is more cosmetically acceptable tha n the lateral scar in the lateral closing wedge osteotomy.