Valgus osteotomy of the humeral neck: a technique for the treatment of humerus varus

Abstract

Proximal humerus varus is defined by both its radiographic and clinical characteristics. Clinically significant humerus varus has a proximal humeral neck-shaft angle less than 140 degrees and causes limited active abduction or forward flexion as a result of impingement of the greater tuberosity on the acromion. Weakness of the shoulder girdle is often present as well. The condition may be congenital, developmental, idiopathic, or posttraumatic in origin. Previous treatments for humerus varus have included acromionectomy and wedge osteotomy with placement of the extremity in a shoulder spica cast. This article describes a technique for treatment involving valgus osteotomy of the humeral neck and tension-band fixation. Correction of the deformity allows markedly improved function of the extremity with significant increases in active and passive abduction, forward flexion, and internal rotation.