Cubitus varus deformity is a common condition affecting the elbow joint, often leading to a noticeable alteration in the arm’s appearance. While it primarily involves a change in the carrying angle of the elbow, it frequently does not result in significant limitations in arm function.
What is Cubitus Varus Deformity?
Cubitus varus deformity describes an angular misalignment of the elbow where the forearm deviates inward towards the body when the arm is extended. This gives the arm a “gunstock” appearance, also known as “gunstock deformity.”
The most frequent cause of cubitus varus is the malunion of a supracondylar humerus fracture, especially those occurring in children. These fractures involve the lower end of the upper arm bone (humerus) just above the elbow joint. When such a fracture heals with incorrect alignment, the resulting deformity becomes apparent.
While malunion of supracondylar humerus fractures accounts for most cases, other less common factors can contribute to cubitus varus. These include injuries to the growth plates around the elbow or congenital factors. The deformity becomes noticeable after the initial bone injury has fully healed.
Identifying Cubitus Varus
Cubitus varus is recognized by the cosmetic appearance of the elbow. The most obvious sign is the altered carrying angle, where the forearm points inward when the arm is straightened, rather than slightly outward. This visible change often prompts individuals to seek medical attention.
The diagnostic process involves a thorough physical examination by a healthcare professional. The doctor will visually assess the alignment of the elbow and evaluate the arm’s range of motion, including flexion, extension, pronation, and supination. While functional limitations are uncommon, any restricted movement can be identified during this assessment.
Imaging studies are important to confirm the diagnosis and quantify the deformity. X-rays are the standard imaging method used to visualize the bones of the elbow and rule out other potential bone issues. Specific measurements, such as Baumann’s angle, are taken from X-rays to assess the varus deformity.
Treatment Options
The main approach to treating cubitus varus deformity is surgical correction, as non-surgical methods are ineffective for addressing the underlying bony misalignment. The main surgical procedure is an osteotomy, which involves cutting the bone to realign it.
During an osteotomy, a wedge of bone is removed from the humerus to restore alignment. Different types of osteotomies exist, such as the lateral closing wedge osteotomy or dome osteotomy, each with specific advantages depending on the nature of the deformity. After the bone is realigned, internal fixation, typically involving plates and screws or K-wires, is used to hold the bone fragments in place while they heal.
The goals of surgical intervention are to improve the cosmetic appearance of the arm by correcting the noticeable angulation. Beyond aesthetics, surgery also aims to prevent potential long-term complications that can arise from the deformity, such as an increased risk of future fractures in the lateral condyle or, in rare cases, delayed nerve issues.
Recovery and Long-Term Outlook
Following surgical correction for cubitus varus, patients can expect a structured recovery period. Initially, the arm is typically immobilized in a cast for several weeks to allow the osteotomy site to heal. Pain management strategies are employed to ensure comfort during this early phase of recovery.
Physical therapy plays an important role once the initial healing has progressed and the cast is removed. Therapy focuses on regaining full strength in the arm and restoring the elbow’s range of motion through targeted exercises. The duration of physical therapy varies but is tailored to each individual’s progress.
The long-term outlook after surgical correction of cubitus varus is generally favorable, with good cosmetic and functional results commonly achieved. Most patients experience a significant improvement in the appearance of their arm and maintain excellent elbow function. While rare, potential complications after surgery can include nerve injury, infection, or a recurrence of the deformity. Regular follow-up appointments with the surgeon are important to monitor healing and address any concerns.