Mohit Dhingra

Background: Post-traumatic cubitus varus is a 3-dimensional deformity that may result in cosmetic dissatisfaction and, in a minority of patients, functional impairment. Translation step-cut osteotomy (TSCO) provides stable correction but may be associated with residual lateral condylar prominence. A modified spike translation step-cut configuration, referred to as the pentagonal osteotomy, has been proposed to enhance medial translation and improve cosmetic contour. This study prospectively compares the clinical, radiologic, and cosmetic outcomes of TSCO and pentagonal osteotomy in pediatric cubitus varus deformity. Methods: This prospective comparative study included 24 children (P =0.603). Radiologic parameters, including the Baumann and HEW angles, improved significantly in both groups, with no significant intergroup differences. LPI improved in both cohorts, with a more negative mean value in the pentagonal group (−9.53±2.44 vs. −5.86±8.71), although this difference was not statistically significant ( P =0.174). A statistically significant difference in postoperative extension deficit of 4 degrees was observed in favor of the TSCO group ( P =0.046), while flexion and rotational correction were comparable. Excellent cosmetic satisfaction was reported by 83.3% of TSCO patients and 91.7% of patients undergoing pentagonal osteotomy ( P =0.592). Conclusion: Both translation step-cut osteotomy (TSCO) and pentagonal osteotomy are safe and effective techniques for the correction of pediatric cubitus varus deformity, with comparable clinical, radiologic, and cosmetic outcomes. Further studies with larger cohorts and longer follow-up are required to determine the long-term advantages of the pentagonal osteotomy, if any. Level of Evidence: Level II—prospective comparative study.

Bone is a common site for metastasis from various malignancies and is considered a poor prognostic indicator for both life expectancy and quality of life. Skeletal metastases lead to severe pain and pathological fractures, significantly impairing patients' daily functioning and well-being. Effective management of impending and pathological fractures is crucial in improving these patients' quality of life. To evaluate the quality of life in patients with metastatic bone disease who underwent surgical treatment for impending and pathological fractures of the lower limb at a tertiary care hospital. This retrospective observational study included patients who underwent surgical intervention for impending and pathological fractures of the lower limb due to metastatic bone disease. Functional outcomes were assessed using the Hindi-translated Indian version of the Toronto Extremity Salvage Score (TESS) for the lower limb. A total of 22 patients were included, with a mean age of 50 years (SD 17.9). The average TESS score for all patients was 48.8 (SD 20.02). The mean follow-up period was 15 months (range 3–56 months). A statistically significant difference in TESS scores was observed when age was considered as a variable (p < 0.05), indicating an age-related impact on functional outcomes. Prophylactic and therapeutic fixation of metastatic fractures significantly improves the quality of life in patients with metastatic bone disease. The use of the Indian version of the TESS questionnaire provided valuable insights into functional outcomes and quality of life in the Indian population.