Osteotomias corretivas em sequelas de fraturas supracondilianas do cotovelo na população pediátrica: revisão bibliográfica sistemática.
Resumo
A deformidade em varo do cotovelo é uma complicação comum das fraturas supracondilares do úmero na população pediátrica, o objetivo foi analisar os diferentes tipos de osteotomias e métodos de fixação para o tratamento dessas lesões.
Materiais e métodos: foi realizada uma pesquisa bibliográfica utilizando as plataformas Pubmed e OVID como mecanismo de busca, as palavras-chave forom Cubitus AND varus AND osteotomy.
Resultados: foram selecionados 13 artigos, com N de 237 pacientes, seguimento de 30 meses, idade no momento da cirurgia foi de 8,78 anos. A técnica de osteotomia mais utilizada foi a ressecção de cunha óssea com base laterala. 35,4% foram fixados com placas, 24,8% com fixações externas e 33,3% foram fixados com kw/pins.
Conclusão: as técnicas de osteotomia utilizadas atualmente conseguem correção angular. Não forom encontradas diferenças significativas entre os resultados das técnicas analisadas. Não existe implante superior a outro na fixação de osteotomias distais do úmero. Cada implante tem vantagens e desvantagens.
Downloads
Referências
Houshian S, Mehdi B, Larsen MS. The epidemiology of elbow fracture in children: analysis of 355 fractures, with special reference to supracondylar humerus fractures. J Orthop Sci. 2001;6:312-315.
Salonen A, Niemi ST, Kannus P, Laitakari E, Mattila VM. Increased incidence of distal humeral fracture surgery and decreased incidence of respective corrective osteotomy among Finns aged 0 to 18 years between 1987 and 2016: a population-based study. J Child Orthop. 2019;13:399-403.
Wilkins KE. Residuals of elbow trauma in children. Orthop Clin North Am. 1990;21:291–314
Herring JA. Upper extremity injuries. In: Tachdjian’s pediatric orthopaedics. 3rd ed. New York: Saunders; 2002. pp. 2115–2250
Acar MA, Yildirim S, Elmadag NH, Senaran H., Ogun TC. Treatment of postraumatic cubitus varus with corrective supracondylar humeral osteotomies using the methyl methacrylate external fixator. J Pediatr Orthop. 2014;34(3):253-9
Omori S, Murase T, Oka K, Kawanishi Y, Oura K, Tanaka H, et al.Postoperative accuracy analysis of three-dimensional corrective osteotomy for cubitus varus deformity with a custom-made surgical guide based on computer simulation. J Shoulder Elbow Surg. 2015;24:242 9. https://doi.org/10.1016/j.jse.2014.08.020
Takeyasu Y, Murase T, Miyake J, Oka K, Arimitsu S, Moritomo H, et al. Three dimensional analysis of cubitus varus deformity after supracondylar fractures of the humerus. J Shoulder Elbow Surg. 2011; 20:440-8.
Abe M, Ishizu T, Shirai H, et al. Tardy ulnar nerve palsy caused by cubitus varus deformity. J Hand Surg [Am]. 1995;20:5–9
Davids JR, Maguire MF, Mubarak SJ, et al. Lateral condylar fracture of the humerus following posttraumatic cubitus varus. J Pediatr Orthop. 1994;14:466–470.
Yang IH, Park HW, Joo SY, et al. Refractures of the upper extremity in children. Yonsei Med J. 2007;48:255–260.
Siris IE. Supracondylar fractures of the humerus: an analysis of 330 cases. Surg Gynecol Obstet. 1939;68:201–222.
Hernandez.MA, Roach JW. Corrective osteotomy for cubitus varus deformity. J Pediatr Orthop. 1994;14:487–491
Raney EM, Thielen Z, Gregory S, Sobralske M. Complications of supracondylar osteotomies for cubitus varus. J Pediatr Orthop. 2012;32:232–240
Solfelt DA, Hill BW, Anderson CP, Cole PA. Supracondylar osteotomy for the treatment of cubitus varus in children. Bone Joint J. 2014;96B:691-700.
Oppenheim WL, Clader TJ, Smith C, et al. Supracondylar humeral osteotomy for traumatic childhood cubitus varus deformity. Clin Orthop Relat Res. 1984;188:34-9.
Hasegawa M, Suzuki T, Kuroiwa T, Oka Y, Maeda A, Takeda H, Shizu K, Suzuki K, Yamada H. Reliability and validity of radiographic measurement of the humerus-elbow-wrist angle in healthy children. JB JS Open Access. 2017;2(1):e0012. doi: 10.2106/JBJS.OA.16.00012. PMID: 30229210; PMCID: PMC6132898.
Kumar B, Pai S, Ray B, Mishra S, Pandey AK. Radiographic study of carrying angle and morphometry of skeletal elements of human elbow. Rom J Morphol Embryol. 2010;51(3):521–6
Goldfarb CA, Patterson JM, Sutter M, Krauss M, Steffen JA, Galatz L. Elbow radiographic anatomy: measurement techniques and normative data. J Shoulder Elbow Surg. 2012;21(9):1236–46. Epub 2012 Feb 12
Wong HK, Lee EH, Balasubramaniam P. The lateral condylar prominence. A complication of supracondylar osteotomy for cubitus varus. J Bone Joint Surg Br. 1990;72:859-61
Moradi A, Vahedi E, Ebrahimzadeh MH. Spike translation: a new modification in step-cut osteotomy for cubitus varus deformity. Clin Orthop Relat Res. 2013;471:1564–1571
Tang X, Wang J, Slongo T, Wang RenHao Ze Y, Zhou R, Li J. Comparison of internal fixation vs. External fixation after corrective osteotomy in children with cubitus varus J Shoulder Elbow Surg. 2020;29:845–852
Persiani P, Noia G, Cristo CD, Graci J, Gurzì MD, Villani C. Lateral wedge osteotomy for pediatric post-traumatic cubitus varus: Kirschner-wires or locking angular plate?. J Ped Ort B. 2017;26(5):405-411
Travis R. Liddell, MD,William L. Hennrikus, MD, James J. Bresnahan, BS. A simple dual-planar osteotomy to correct cubitus varus deformity in children. J Orthop Trauma 2016;30:e340–e345
Xinyue Hu. Meiling Zhong.Yue Lou. Clinical application of individualized 3D printed navigation template to children with cubitus varus deformity. J Ort Surg Res. 2020;15:111.
Singh Verka P, Kejariwal U, Singh B. Management of cubitus varus deformity in children by closed dome osteotomy.Journal of clinical and diagnostic research. J Clin Diagn Res. 2017;11(3):RC08–RC12.
Ali A, Abouelnas B, Elgohary HSA. Dome osteotomy using the paratricipital (triceps-sparing) approach for cubitus varus deformity in children: a surgical technique to avoid lateral condylar prominence. J Ped Ort B. 2016;25:62–68
Eamsobhana P, Kaewpornsawan K. Double dome osteotomy for the treatment of cubitus varus in children. International Orthopaedics (SICOT). 2013;37:641–646. DOI: 10.1007/s00264-013-1815-7
Belthur MV, Iobst CA, Bor N, Eidelman M. Correction of cubitus varus after pediatric supracondylar elbow fracture: alternative method using the taylor spatial frame. J Pediatr Orthop. 2016;36:608–617
Vashisht S, Sudesh P, Gopinathan NR. Results of the modified reverse stepcut osteotomy in paediatric cubitus varus. International Orthopaedics. 2020;44:1417–1426.
Bali K, Sudesh P. Modified step-cut osteotomy for post-traumatic cubitus varus: our experience with 14 children. Orthopaedics & Traumatology: Surgery & Research. 2011;97:741-749
Handelsmana JE, Weinberga J, Hersch JC. Corrective supracondylar humeral osteotomies using the small AO external fixator. J Ped Ort B. 2006;15:194–197.
Copyright (c) 2024 Marcelo Juárez, Juan Pedro Filippini Irazún, María Elena Pérez Carrera
This work is licensed under a Creative Commons Attribution 4.0 International License.
Os autores mantêm seus direitos autorais e cedem à revista o direito de primeira publicação de seu trabalho, que estará simultaneamente sujeito à Licença Creative Commons Atribuição 4.0 Internacional. que permite a partilha do trabalho desde que seja indicada a publicação inicial nesta revista.
