Correction of Cubitus-Varus Deformities in Children Using the Taylor Spatial Frame

Introduction: Cubitus-varus is a well-known complication of a malunited fracture of the distal humerus in children and adolescents. Standard treatment of this deformity needs significant exposure and is associated with high complications rates. We present our experience with percutaneous distal humeral osteotomy and 3D correction, using the Taylor Spatial Frame (TSF).

Methods: Between the years 2011-2015, we operated on six patients (four females, two males) with a mean age of 9.5 (range 8-12) years. All patients had malunion of the distal humeral supracondylar fractures and severe cubitus varus deformities. All patients had at least two planes of deformity to correct. Mean carrying angle was 21 (range 19-23) degrees varus. We evaluated all patients` files and x-rays and examined the patients. All patients or parents completed Quick Dash assessment scores.

Results: All patients achieved correction goals. The carrying angle of the elbow was corrected to within the range of the normal population. All had a full range of motion on the last follow-up. One patient underwent re-operation a week after the initial surgery due to mispositioning of the distal half pins. No other complications were recorded. All patients and parents were satisfied with the achieved correction results.

Conclusion: Based on our initial experience, we believe that TSF is an accurate and predictable method for correction of this complex condition. However, there are many pitfalls of the operative technique and, therefore, meticulous adherence to external fixation rules and principles is highly advisable.