Objective To investigate the effectiveness of lateral closing wedge osteotomy for treatment of traumatic cubitus varus deformity in children. Methods Between July 1996 and June 2010, 20 cases of traumatic cubitus varus deformity after humeral supracondylar fracture were treated by lateral closing wedge osteotomy. There were 13 boys and 7 girls, aged from 7 to 14 years (mean, 10.6 years). The left elbow was involved in 12 cases and right elbow in 8 cases. Thirteencases had received closed reduction, percutaneous Kirschner wire fixation, and external fixation in other hospital, and 7 cases misdiagnosed as elbow luxation and soft tissue injury had given external fixation. Cubitus varus deformity occurred at 2-12 years after injury. Preoperatively, the elbow range of motion (ROM) in flexion and extension was 100-150° (mean, 133.0°) and 0-24° (mean, 11.7°), respectively. The angle of cubitus varus deformity was 20-50° (mean, 32.1°). Results All incisions healed by first intention, and no related complication occurred. A total of 17 patients were followed up 1-14 years (mean, 5 years). X-ray films revealed that bone union was achieved in all cases within 5-8 weeks after operation (mean, 6 weeks). The deformity of cubitus varus was corrected in all cases. At last follow-up, the elbow ROM in flexion and extension was 110-150° (mean, 135.9°) and 0-27° (mean, 12.9°), respectively. According to Jupiter et al. elbow score system, the results were excellent in 14 cases, good in 2 cases, and fair in 1 case; the excellent and good rate was 94.1%. One patient underwent recurrence at 1 month after removal of the Kirschner wire, and lateral closing wedge osteotomy was performed again after 1 year. Conclusion Lateral closing wedge osteotomy is a safe and effective surgical procedure in correcting traumatic cubitus varus deformity in children, which is easy to operate and can be effective in reducing the complications.
Objective To summarize the effectiveness of bone cement combined with screws for repairing tibial plateau defect in total knee arthroplasty (TKA). Methods Between March 2013 and March 2016, 30 patients were treated with TKA and bone cement combined with screws for repairing tibial plateau defect. Of the 30 patients, 8 were male and 22 were female, with an average age of 64.7 years (range, 55-71 years). And 17 cases were involved in left knees and 13 cases in right knees; 22 cases were osteoarthritis and 8 cases were rheumatoid arthritis. The disease duration ranged from 9 to 27 months (mean, 14 months). Knee Society Score (KSS) was 41.63±6.76. Hospital for Special Surgery Knee Score (HSS) was 38.10±7.00. The varus deformity of knee were involved in 19 cases and valgus deformity in 11 cases. According to the Rand classification criteria, tibial plateau defect were rated as type Ⅱb. Results All incisions healed by first intention, without infection or deep vein thrombosis. All the patients were followed up 27.5 months on average (range, 10-42 months). At last follow-up, HSS score was 90.70±4.18 and KSS score was 93.20±3.75, showing significant differences when compared with preoperative values (t=–58.014, P=0.000; t=–60.629, P=0.000). Conclusion It is a simple and safe method to repair tibial plateau defect complicated with varus and valgus deformities with bone cement and srews in TKA.