Pediatric Orthopedic Surgeons treating Fused Toes

CUBITUS VALGUS

Cubitus valgus is also known as a “turned-out elbow” or “varus deformity. It is a condition in which the forearm is angled away from the body when the arm extends. This causes the elbow to point away from the body. Cubitus Valgus can result in a noticeable deformity, and can also cause pain and difficulty with activities such as throwing or lifting.

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.

Cubitus Valgus

Cubitus ValgusThe elbow joint, a synovial hinge joint that joins the upper arm and forearm, allows for the important movement of the hand toward and away from the body during daily tasks. Cubitus valgus is the medical term for an excessive carrying angle of the elbow. In addition, one of the key needs for the Defense forces is the ability to fire a target, and an individual with an irregular elbow-carrying angle may find it challenging to aim the target. Furthermore, it is challenging to carry weight for those who have an incorrect elbow-carrying angle because their hands frequently bump against their hips. Moreover, the term “Gunstock Deformity” refers to a reduction in the angle between the forearm and hand.

With cubitus valgus, the forearm angles outward away from the body when the arm remains completely extended. Cubitus valgus bilateral refers to the condition when this condition affects both arms. If your child’s carrying angle, or the degree that your child’s arm is angling away from their body, is greater than 15 degrees with the palm facing up and the arm extended, you child may have cubitus valgus. The carrying angle must equate between 3 and 29 degrees in order to classify as cubitus valgus. Women frequently demonstrate a more prominent angle. Although this ailment normally does not appear serious, in some children it might compress the arm’s nerves and lead to problems.

Causes that Develop Cubitus Valgus

Cubitus valgus has two potential causes:

  • A fracture
  • A congenital condition

A: Fractures

  • Post-traumatic malunited humerus fracture
  • Malunited fracture lateral condyle
  • Trochlear osteonecrosis (static)
  • Malunited intercondylar fracture (static)
  • Malunited medial condyle fracture (static)

B: Congenital Condition

The following two congenital ailments frequently result in cubitus valgus:

  • Turner syndrome
  • Noonan syndrome.

When a female is born with only one X chromosome, it is known as Turner syndrome. Short height and delayed puberty are two more symptoms that people with Turner syndrome suffer from. Hormone replacement therapy is the most popular type of treatment. Noonan syndrome is a different genetic disorder that results in delayed development. Although a genetic mutation is frequently to blame, it can occasionally occur for unknown reasons. A cure for Noonan syndrome does not presently exist; although, there are some therapies that can lessen its consequences. 

QUESTIONS AND ANSWERS

What is cubitus valgus in children, and what causes it?

Cubitus valgus refers to a condition characterized by an abnormal outward angulation of the forearm at the elbow, causing the arm to deviate away from the body. In children, this condition typically occurs due to a growth plate injury, commonly known as a supracondylar humerus fracture. When the growth plate becomes injured, it can affect the alignment of the forearm bones, resulting in cubitus valgus.

What are the common symptoms and signs of cubitus valgus in children?

Children with cubitus valgus may present with a visibly angled forearm at the elbow, often described as “gunstock deformity.” Other symptoms may include limited range of motion in the affected elbow, difficulty fully extending or bending the arm, and potential discomfort or pain in the elbow region. The degree of deformity and associated symptoms can vary based on the severity of the condition.

How do doctors diagnose Cubitus Valgus?

Diagnosis involves a physical examination and imaging studies, such as X-rays, to assess the degree of deformity and confirm the diagnosis. Treatment options depend on the severity of the cubitus valgus. In milder cases, doctors may just observe and monitor the child. This normally occurs when the child does not experience significant functional limitations or pain. Doctors may recommend physical therapy to improve range of motion and strength. In more severe cases, where the deformity affects function or causes discomfort, surgical intervention may be necessary to realign the bones and correct the deformity.

Call for an Appointment

If your son or daughter is suffering from elbow problems, make an appointment with the doctors at Medical City Children’s Orthopedics and Spine Specialists

Complications of Cubitus Valgus

Ulnar neuropathy has been linked to cubitus valgus. This is a condition that affects the ulnar nerve, one of the three main nerves in the arm. Ulnar neuropathy most commonly occurs when the ulnar nerve is compressed or irritated, causing numbness, tingling, and sometimes weakness. In most cases, treatment includes limiting physical activity and wearing braces. However, if these conservative treatments do not result in successful treatment, doctors will recommend surgery. Elbow valgus can also cause a condition called delayed ulnar nerve palsy, which indicates a type of ulnar neuropathy.

This is a chronic condition often associated with elbow valgus. Ulnar nerve palsy is progressive and usually worsens over time. Your child may experience loss of sensation, loss of coordination, tingling, burning, pain, and weakness in your child’s fingers, especially the ring finger and little finger. There are many treatments for symptoms of ulnar nerve palsy, including over-the-counter medications and physical therapy.

Physical Therapy for Cubitus Valgus?

Your child will generally not require therapy if cubitus valgus isn’t putting pressure on the ulnar nerve. Treatment options for cubitus valgus often include osteotomy or fixation. Your doctor will perform an osteotomy in order to restructure the bone and alter its alignment. Children with cubitus valgus have been treated using distraction osteogenesis, a specific kind of osteotomy.

Treatment

Doctors believe that the Llzarov technique is a safe approach to treating cubitus valgus without an ugly scar or a limited range of motion. With progressive controlled, coordinated stretching a positive result occurs.  The most frequent elbow fracture in children is a fracture of the lateral condyle. Malunion of the cubitus valgus occurs regularly. The majority of surgeries include challenges and complexities due to technology. Under- or overcorrection, neuropraxia, an unattractive scar, refracture at the osteotomy site, a restriction in elbow range of motion, infection, and nerve damage are a few of these. With the use of an elbow splint, corrective stretching, strengthening of weak muscles, and joint mobilization exercises are somewhat effective.

Physiotherapy treatment

  • Joint pain and stiffness are reduced with a hot fermentation.
  • The muscles of the arm and forearm can be released gently.
  • Using a wand, gentle active, and active-assisted activities should occur throughout the day in a pain-free environment.
  • Isometric exercises that target the arm and forearm
  • Avoid weight lifting.
  • Corrective Splint.

Surgical treatment

The two most common treatments for cubitus valgus are osteotomy and fixation. Your doctor will perform an osteotomy in order to restructure the bone and alter its alignment. Children with cubitus valgus have been treated using distraction osteogenesis, a specific kind of osteotomy. Making a longer bone from a shorter one describes how this procedure functions. Surgeons use a distractor to pry apart the bone that was sliced during surgery, a technique that causes very minor discomfort. A longer bone will replace a shorter one by growing new bone in the space left by the distractor.

Fixation is the procedure your doctor will use to rejoin the elbow’s bones, typically after a fracture. The Lizarov method of distraction osteogenesis for cubitus valgus elbow deformity appears as an effective, safe, stable, and dependable procedure that prevents ugly scar formation and loss of range of motion. It offers benefits, including the ability to make more corrections during the period of distraction and the ability to quickly resume everyday duties. Developmental disorders, trauma, or altered adaptations to repeated stress can cause extreme elbow carry angles.

The three bones’ (radius, humerus, and ulna) poor alignment or hypomobility are the main causes of Cubitus Valgus. Excessive carrying angle places extra strain on the elbow structures, rendering them more vulnerable to traction problems. It also makes walking and carrying a burden difficult. To decrease the carrying angle, there are yoga and physical therapy exercises that help, and of course, surgery remains an option. At Medical City Children’s Orthopedics and Spine Specialists, we provide non-surgical and surgical treatment options for cubitus valgus.

Why Choose Medical City Children’s Orthopedics and Spine Specialists

The very first reason parents choose Medical City Children’s Orthopedics and Spine Specialists for their children is because we are experts in children’s health.  Parents should want their child treated by experts and we will provide that expertise.  We do it all the time in our ArlingtonDallas, Flower Mound,  Frisco, and McKinney, TX offices.  Finally, to obtain the very best diagnosis and treatment, we invite parents to give us a call to make an appointment for their child.

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Footnote:

Healthline: Cubitus Valgus

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