Modified French Osteotomy
Modified French Osteotomy
ABSTRACT
Objective: To evaluate the outcome of Modified French Osteotomy for correction of cubitus varus deformity.
Design & Duration: Descriptive quasi-experimental study from Feb. 2000 to Oct. 2003.
Setting: Dept. of Orthopaedics and Trauma, Post-Graduate Medical Institute, Hayatabad Medical Complex, Peshawar.
Patients: All children, aged 3-12 years, with cubitus varus deformity were included in the study.
Methodology: Pre-operative clinical as well as radiological assessment of upper extremities were done in all cases.
Modified French osteotomy was done to correct the deformity. All patients were followed for seven months. Physical
examination for the range of motion, scar and post-operative complications were assessed. Antero-posterior and
lateral radiographs of the elbow were obtained, and the carrying angles and lateral condylar prominence index were
measured and recorded.
Results: Out of the total 30 patients, 26 were male and four female. Left side was involved in 24 cases and the right
side in six. The average age at the time of osteotomy was seven years (range 3½-12 years). The average pre-operative
carrying angle was 25.2o (range 18-30o) and the post-operative angle 8.7o (range 5-13o valgus). The average pre-
operative range of motion was 122.6o (range 105-135o) and the post-operative range 123.86o (range 90-135o). The
average pre-operative lateral condylar prominence index (LCPI) was 175.56 (range 128-232) and the post-operative
lateral condylar prominence 156 (range 100-240). Based on Bellmore criteria, 25 patients showed excellent, three
good and two a poor result.
Conclusions: Modified French technique of supracondylar osteotomy has excellent results in the management of
cubitus varus in terms of cosmesis, radiological findings and fewer complications.
may lead to posterolateral rotatory instability of the some cases where additional rotational deformity was
elbow12,14. identified, then correction was attempted by placing the
screws in different positions in the sagittal plane. The
Understanding the biomechanical forces of this combin- wedge was cut with an oscillating saw, leaving the me-
ation of deformities will guide treatment rationale in dial cortex intact to be cracked as a hinge, thereby ap-
the future. Cubitus varus deformity secondary to distal proximating the screws. The screws were then wired
humeral malunion is not necessarily a benign condition, together in a figure of eight fashion and the wound clo-
and may have significant long term implications relating sed. Post-operatively, the elbow was placed in 90o flex-
to elbow instability, medial elbow pain from subluxation ion with the forearm in neutral position in a long arm
of the medial head of the triceps over the epicondyle, back slab for three weeks, after which mobilization was
and ulnar neuritis or neuropathy. Preventive corrective started.
osteotomy is an intervention that may merit conside-
ration19-23. Follow-up Assessments
All the patients were asked to return to the hospital for
This study was designed to evaluate the outcome of clinical and radiological evaluations for a period of se-
French modified osteotomy for cubitus varus deformity. ven months. Physical examination included assessment
The study carries great significance as it evaluates the of the scar, carrying angle and ROM. X-rays of elbow
outcome of a commonly performed procedure for a in anteroposterior and lateral views were taken and the
common deformity. carrying angle measured. Carrying angle, lateral condylar
prominence index and range of motion were used as
PATIENTS & METHODS strict criteria to categorize the results (Table I).
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