An 8-year-old boy who sustained a neglected Gartland Type III supracondylar fracture presents two years later with a cubitus varus ('gunstock') deformity. Besides varus tilt, the other components of this three-dimensional deformity are:

• A External rotation and hyperextension of the distal fragment ✓
• B Internal rotation and extension of the distal fragment
• C External rotation and flexion of the distal fragment
• D Internal rotation and flexion of the distal fragment

Explanation

Post-traumatic cubitus varus after supracondylar malunion is a three-dimensional deformity consisting of varus in the coronal plane, hyperextension in the sagittal plane, and external rotation of the distal humeral fragment in the transverse plane. Corrective treatment is a supracondylar valgus derotation osteotomy, which addresses all three components. Internal rotation is the mirror-image error seen with posteromedially displaced extension-type fractures corrected wrongly, ruling out options B and D.

Reference: Tachdjian's Pediatric Orthopaedics, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.