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Paediatric orthopaedic disorders
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Match the list of options above with the most likely clinical scenario below. Each option may be used once, more than once, or not at all. Genu varum in a 10-month-old male.A 4-year-old child with an undisplaced proximal tibial metaphyseal fracture.An 11-year-old premenarcheal girl with idiopathic scoliosis.An 8-year-old male with recent onset of hip pain and radiographs showing Legg–Calvé–Perthes’s disease.A 14-year-old female with remote history of elbow injury with cubitus varus deformity.A 12-year-old male with diplegic cerebral palsy who underwent multiple soft tissue release surgeries at the age of 6.
The elbow
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Varus and valgus deformities (cubitus varus and cubitus valgus) are usually the result of trauma around the elbow. A varus deformity can be demonstrated by asking the patient to abduct the shoulders to 90 degrees with the palms facing forwards: the arm takes on the appearance of a rifle butt (gunstock deformity).
Cubitus varus and valgus
Published in Benjamin Joseph, Selvadurai Nayagam, Randall Loder, Ian Torode, Paediatric Orthopaedics, 2016
If progressive cubitus varus or valgus become very severe, instability of the elbow may ensue. Apart from the instability in the coronal plane two other forms of instability may develop following cubitus varus. Long-standing cubitus varus can result in tardy rotatory instability of the elbow6 and recurrent posterior dislocation of the radial head. The latter problem usually follows a fresh episode of trauma.7 These reports suggest that cubitus varus may not be merely a cosmetic problem and highlight the need to correct the deformity to prevent complications that may arise in the long term.
9 years’ follow-up of 168 pin-fixed supracondylar humerus fractures in children
Published in Acta Orthopaedica, 2018
Noora Tuomilehto, Antti Sommarhem, Aarno Y Nietosvaara
The remodeling capacity of the distal humerus is limited (Otsuka and Kasser 1997, Omid et al. 2008, Flynn et al. 2015). Malunion in the frontal plane has been considered predominantly as a cosmetic disability, although elbow pain and dysfunction as well as an increased risk of lateral humeral condyle fractures have been reported (Guven et al. 2015). Sagittal plane malunion can lead to permanent changes in elbow range of motion (ROM) (Sinikumpu et al. 2016). Long-term outcome of SCHF is usually assessed clinically by Flynn’s criteria (Flynn et al. 2015), which define unsatisfactory results as more than 15˚ asymmetry in elbow ROM or carrying angle (CA). The subjective outcome has been evaluated with validated scoring systems such as the Pediatric Outcome Data Collection Instrument (PODCI), the Mayo Elbow Performance score, and QuickDASH. The limitation of these validated outcome measures is the absence of questions concerning cosmetic outcome, which in our opinion is a weakness, since the most common complication of SCHF, cubitus varus, is mainly considered a cosmetic problem.
Evaluation of A Better Approach for Open Reduction Of Severe Gartland Type III Supracondylar Humeral Fracture
Published in Journal of Investigative Surgery, 2021
At the final visit, all patients were evaluated functionally and radiologically. The carrying angle and range of motion of the operated side were compared with those of the normal elbow. The Baumann angle was evaluated in the coronal plane. We classified the surgical outcomes by the Flynn criteria as follows [10]: excellent, the elbow joint can be normally flexed and extended, with a carrying angle of 10°–15°; good, the elbow joint flexion is reduced by 5°, with a decreased carrying angle or cubitus varus of 0°–5°; fair, the elbow joint flexion is reduced by 0°–10°, with a cubitus varus of 6°–10°; and poor, the elbow joint flexion is reduced by >5°, with a cubitus varus of 11°–15°.