Varus Deformity

Varus deformity is the deformity of the limb in which it deviates toward the midline of the body. Cubitus varus is deformity of the elbow resulting in deviation of the forearm toward the midline of the body. The condition is also referred to as gun stock deformity. Cubitus varus deformity is the most common complication of supracondylar fracture caused due to poor healing. Supracondylar fracture is the most common elbow fracture occurs after a fall from an outstretched arm.

Causes

Cubitus varus deformity may occur because of growth disturbances, but it probably results from malreduction of the supracondylar fracture with medial displacement of the distal fragments. Cubitus varus deformity, also known as bow-elbow is unsightly in appearance and does not cause functional disability.

Diagnosis

Your doctor will diagnose the deformity by physical examination. Your doctor will evaluate the level of deformity by measuring the carrying angle of the arm. It is the angle created with the extended arms at the sides and the palms facing forward with the forearm and hands placed away from the body. As the carrying angle varies from person to person it is necessary to compare with the opposite arm. In case of cubitus varus carrying angle is decreased as the arm points toward the midline of the body. X-rays may be needed to look for the deformity.

Treatment

Elbow with mild deformity do not require any treatment, however severe deformity may require surgical reconstruction for cosmetic reasons. Various surgical techniques to correct the deformity include closing wedge, opening wedge, dome pentalateral, and three dimensional osteotomies. The most accepted technique is lateral closed wedge (LCW) osteotomy, a safe and effective method to correct the cubitus varus deformity.

Surgical procedure involves cutting of bone and removal of an appropriate wedge of bone from the lateral side of the lower humerous and then closing the gap. The osteotomy is stabilized and fixed by two screws using figure of eight tension band wire between them followed by supplementation of fixation with two small lateral K-wires to prevent loss of correction. Upper limb was immobilized with long-arm splint with the elbow flexed at 90° for a 3 week interval.

Possible risks and complications after the surgery include infection, scar formation, stiffness, loss of fixation and permanent deformity.