Long-term results of remodeling of lateral condylar prominence after lateral closed-wedge osteotomy for cubitus varus

Background: Despite the ability of lateral closed-wedge osteotomy for cubitus varus deformity to restore carrying angle and preserve elbow motion, there have been reports of poor cosmetic appearance of the elbow because of lateral condylar prominence. Method: We evaluated long-term results of remodeling of lateral condylar prominence after osteotomy in 11 patients (7 of the prepuberty group, 4 of the postpuberty group). The follow-up period ranged from 4.7 to 14.2 years (average, 10). Results: The mean preoperative and postoperative lateral condylar prominence index (LCPI) of the affected elbow were -1.2% and 36%, respectively. At final follow-up, the mean LCPI of the corrected elbow was 11.1%. In the prepubertal group, the mean LCPI decreased from 41.2% after surgery to 5.2% at final follow-up, whereas it decreased from 26.8% to 21.3% in the postpubertal group. The difference in reduction between the mean postoperative LCPI and the mean LCPI at final follow-up in the prepubertal group (36%) was greater than in the postpubertal group (5.4%) (P = .006). Conclusion: Lateral closed-wedge osteotomy is a relatively simple and effective procedure for correction of cubitus varus deformity before puberty, allowing cosmetically pleasing remodeling of lateral condylar prominence. Level of evidence: Level 4. (C) 2009 Journal of Shoulder and Elbow Surgery Board of Trustees.