Osteotomy pada Supracondylar Humerus

1. Lateral Closed Wedge (French) Osteotomy

2. Three-dimensional osteotomy
3. Modified step cut osteotomy
4. Dome shaped Osteotomy

1. Lateral Closed Wedge (French) Osteotomy

- the simplest and most commonly used but it only corrects the varus angulation and not the
rotational or sagittal plane elements
- a further problem with this osteotomy is that it leaves the patient with a lateral prominence,
unless medial translation of the distal fragment is also incorporated into the correction
2. Three-dimensional osteotomy
- involves removal of a lateral wedge with rotation and correction of hyper-extension. This
therefore allows correction of elements that are not addressed with a simple lateral closing wedge
osteotomy
- it adds complexity and reduces the surface area for fixation and so increases the risk of non-
union or failure of fixation

3. Modified step cut osteotomy

- a triangular osteotomy is performed and the lateral edge of the distal fragment is moved into the
apex of the proximal osteotomy site
- The degree of correction is increased as the apex of the triangle is moved medially
4. Dome shaped osteotomy
- A dome is a curved osteotomy that is performed through a posterior approach
- This allows correction of the deformity in all planes however it is technically demanding
(Edwardson,et al. Paediatric supracondylar fractures: an overview of current management and
guide to open approaches. Journal of Orthopaedic and Trauma. 2013; Vol 27;5)