• J Nowotny, F Thielemann, A Biewener, and K D Schaser.
• UniversitätsCentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland. joerg.nowotny@uniklinikum-dresden.de.
• Oper Orthop Traumatol. 2017 Apr 1; 29 (2): 138-148.

ObjectivesCorrecion of elbow joint deformities that usually develop secondary to direct or indirect trauma of the arm or elbow with subsequent inadequate healing and consecutive axial/rotational malalignment and may be associated with cosmetic or functional deficits of the arm.IndicationsRelevant malalignment of the arm axis with corresponding cosmetic or functional deficits for the patient.ContraindicationsPre-existing degenerative and chronic inflammatory changes.Surgical TechniqueGenerally, two-dimensional supracondylar open or closed wedge osteotomies are used. In the presence of a three-dimensional deformity (with rotational component), an additional derotational correction is necessary. Extra-articular deformities following extension fractures should be treated preferably with an open wedge osteotomy, extra-articular deformities of flexion fractures with a closed wedge osteotomy. Valgus/varus deformities may also require a closed/open wedge osteotomy primarily through a dorsal or alternatively radial approach.Postoperative ManagementThe arm should be immobilized with a brachial cast splint for 2-3 weeks, with passive exercises of the elbow starting on postoperative day 7.ResultsIn general, the results for a three-dimensional osteotomy of the distal humerus are expected to be good to very good. Only in rare cases (2.5%) is a mostly transient irritation of the ulnar nerve observed.

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