Long-term nonunion of the lateral humerus condyle fracture may lead to progressive cubitus valgus, elbow pain and instability, and secondary ulnar neuritis. A number of techniques of osteotomy are available for correction, but each has its disadvantages. The aim of this study was to present a technique of medial trapezoidal osteotomy for correcting nonunion of the lateral humeral condyle with an elbow valgus deformity >20°.
Eight patients (mean age, 7.5 years) with cubitus valgus, after neglected nonunion of a lateral humeral condyle fracture of greater than 2 years duration, were treated with trapezoidal combined osteotomy. The mean interval from the lateral condylar fracture to surgery was 3.1 years. The osteotomy lines were marked on the bone with a template made before surgery. The lateral condyle and osteotomy site were fixed with K-wires, and the elbow joint was immobilized in a plaster brace. Pre- and postoperative carrying angles, range of motion, elbow function, and ulnar nerve neuropathy were analyzed.
The mean follow-up was 5.9 years. Union of the lateral condyle was achieved in all patients; 3 healed at 8 weeks, 2 healed at 9 weeks, 2 healed at 10 weeks, and 1 healed at 12 weeks. The mean carrying angle decreased from 30.1° before surgery to 5.8° after surgery. The surgery did not reduce the range of motion at the elbow. According to the Mayo Elbow Performance Score, 6 patients had excellent elbow function, and 2 had good elbow function at the last follow-up. All preoperative ulnar nerve symptoms resolved. One patient had a mild surgical site infection. No other complications occurred.
Medial trapezoidal osteotomy appears to be an effective method for treating nonunion of lateral humeral epicondyle fracture with cubitus valgus deformity.
Type of study/level of evidence
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Published online: January 19, 2023
Accepted: November 24, 2022
Received: February 4, 2022
Publication stageIn Press Corrected Proof
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Bo He and Hai Zhao contributed equally to this manuscript.
© 2023 by the American Society for Surgery of the Hand. All rights reserved.