Korrektur posttraumatischer Valgus- und Varusdeformitäten

Elbow deformities, including cubitus varus and cubitus valgus, are the most common late sequelae of distal humerus fractures in childhood, especially supracondylar and lateral condylar fractures. Various osteotomy procedures are used to correct these deformities, such as the lateral closing-wedge osteotomy, step-cut osteotomy, dome osteotomy and multiplanar osteotomy. Closing-wedge osteotomy is most commonly used but can result in lateral epicondylar protrusion (caused by radial displacement of the distal humeral fragment in relation to the proximal humeral shaft, which can result in protrusion of the lateral humeral condyle). Step-cut osteotomy and dome osteotomy offer solutions to this problem but are more complex and carry a higher risk of complications. The dome osteotomy is suitable for varus and valgus deformities without significant malrotation. Although the influence of rotation on the functional outcome is controversial, multiplanar osteotomy is indicated in cases of severe malrotation. When planning the surgical correction, the possible need for ulnar nerve transposition must be considered. The search for simple and effective techniques with low complication rates and high patient satisfaction is important for future development in this field.