Gunstock deformity in children

Gunstock deformity (cubits varus) in children is a condition that affects the alignment of the arms, specifically the forearm and elbow.

This deformity, also known as cubitus varus, can have a significant impact on a child’s quality of life and mobility.

In this article, we will explore what gunstock deformity is, its causes, and the various treatment options available to correct it.

What is Gunstock Deformity?

Gunstock deformity is a condition where a child’s elbow bows outwards, creating an appearance similar to a gunstock. In simple terms, it means that the child’s elbow deviates away from the body, which can hinder their ability to fully extend and flex their arm.

Causes of Gunstock Deformity

1. Fractures: The most common cause of gunstock deformity in children is a prior fracture of the elbow. Supracondylar fractures of the humerus are what is most commonly associated with this deformity. If not adequately treated, fractures can result in malalignment, leading to a gunstock deformity.
2. Growth Plate Injuries: Injuries to the growth plates (physis) of the elbow can disrupt normal bone growth, potentially leading to deformities.
3. Congenital Factors: In some cases, children may be born with a congenital predisposition to this deformity, although this is relatively rare.
4. Rickets: A vitamin D deficiency can weaken the bones, causing various deformities, including gunstock deformity.

Diagnosing Gunstock Deformity

Diagnosing gunstock deformity typically involves a physical examination and imaging studies, such as X-rays or MRI, to assess the extent of deformity and its underlying causes.

Long term complications associated with cubits varus

1. Increase risk of elbow fractures. A gunstock deformity puts the elbow at risk of lateral condyle fractures.
2. Cosmetically unappealing. The elbow will always be sticking out which mayn’t look very nice.
3. Tardy ulnar nerve palsy.

Treatment Options for Gunstock Deformity

The good news is that gunstock deformity in children is treatable. The appropriate treatment option will depend on the child’s age, the severity of the deformity, and its underlying cause.

1. Observation: In mild cases or when the child is very young, observation may be recommended to see if the deformity corrects itself as the child grows. This is recommended if the curve at the elbow is less than 25degrees.
2. Physical Therapy: Physical therapy can help improve the range of motion and strength in the affected arm.
3. Bracing: Orthopedic braces or splints may be used to encourage proper alignment and growth of the bones. This is often considered for children who have mild deformities.
4. Surgery: In more severe cases, or when the deformity is due to a growth plate injury, surgery may be required. Most angulations more than 25degrees may need to be fixed surgically. The surgical procedures may involve osteotomies (bone cuts) or the insertion of plates and screws to realign the bones properly.
5. Vitamin D Supplements: If rickets is the underlying cause, vitamin D supplements may be prescribed to address the deficiency and promote bone health.

Can I leave with my gunstock deformity with out any treatment?

Yes, you can. Many people opt out of surgery to fix the gunstock deformity. Having a gunstock deformity mayn’t affect the functioning of the hand.

Post-Treatment Care

The children will often need a cast for about 4 to 6weeks following the surgery.

After treatment, it is crucial for children to undergo rehabilitation to regain their range of motion and strength. This often includes regular physical therapy sessions and follow-up appointments with the orthopedic surgeon to monitor progress.

Conclusion

Gunstock deformity in children can significantly impact their daily life and functionality. However, with early diagnosis and appropriate treatment, most children can experience significant improvements in their arm alignment and function.

If you suspect your child has gunstock deformity, consult with a pediatric orthopedic specialist to determine the best course of action. Remember that every child is unique, and the treatment plan should be tailored to their specific needs for the best possible outcome. Early intervention and adherence to the recommended treatment plan can help your child enjoy a healthy and active life.

By understanding gunstock deformity and the available treatment options, parents and caregivers can take the necessary steps to ensure their child’s health and well-being.