Valgus Osteotomy of the Proximal Humerus to Treat Humerus Varus in Children.

Abstract

Humerus varus is a rare disease in children that can cause limited active abduction and forward flexion of the shoulder as well as upper limb length discrepancies. Valgus osteotomy of the proximal humerus is an effective method to treat this disease, although internal fixation with a plate and screws is rarely reported. The purpose of this article is to investigate the clinical outcome and radiographic changes of valgus osteotomy of the proximal humerus through internal fixation with a plate and screws. From April 2005 to August 2011, our group treated 5 patients including 1 girl and 4 boys. The left side was the affected side in all cases. The mean operation age was 13 years. We performed valgus osteotomy of the proximal humerus with internal fixation provided by a plate and screws to treat these patients. Follow-ups were performed with an average of 35.6 months (range, 24 to 74 mo). The changes in postoperative shoulder function and radiographic images were analyzed. The actual cause of the humerus varus was not clear. Abduction and forward flexion of the shoulder were significantly increased in all patients. However, there was no obvious improvement in upper limb length. The postoperative humeral neck-shaft angle improved notably as well. We used a paired t test for statistical treatment. The P value was 0.001. No bony nonunion or delayed union was observed. The time required for union was 3 to 6 months. No obvious complications occurred. Valgus osteotomy of the proximal humerus using a plate-screw fixation method can correct the deformity and provide strong fixation in children. The postoperative improvement of shoulder motion and radiologic changes were satisfactory. However, we need to do second operation to remove the plate. Meanwhile, the patients would require a second operation to elongate the affected limb.