Dome osteotomy for cubitus varus correction in a 26-year-old male with left elbow gunstock deformation: a case report.

BACKGROUND

Cubitus varus deformity is a common complication of untreated elbow fractures in children but is rare and challenging to treat in adults. This study presents the first documented case of correcting cubitus varus deformity in an adult.

CASE PRESENTATION: A 26-year-old male laborer presented with a deformed left elbow and impaired limb function due to a childhood fall. Clinical examination revealed a 30-degree cubitus varus deformity (Grade IV), confirmed by X-rays of the limb showing malunion with increased Baumann's and metaphyseal-diaphyseal angle. The surgical intervention involved a dome osteotomy using a triceps-splitting approach under general anesthesia. The deformity was corrected by manipulating the distal fragment in the coronal and sagittal planes and fixing it with a dynamic compression plate and interfragment screw. Postoperative care included immobilization in a long arm cast and progressive rehabilitation.

CLINICAL DISCUSSION: This case demonstrates the effectiveness of dome osteotomy in correcting adult cubitus varus deformity. The technique provides precise correction by targeting the center of rotation of angulation, ensuring superior bone contact and stability. It also minimizes periosteal dissection, reducing the risk of thermal necrosis and preserving bone length. As compared to other osteotomy techniques, dome osteotomy allows for correction in multiple planes and achieves better functional and cosmetic outcomes, despite being technically demanding.

CONCLUSION

Dome osteotomy is an effective surgical option for correcting cubitus varus deformity in adults, providing excellent functional and aesthetic results. This case highlights the importance of precise preoperative planning and meticulous surgical execution for optimal outcomes in patients with complex deformities.