{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:42:31Z","timestamp":1787755351112,"version":"build-2784847793"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>This report describes the case of an athletic 12-year-old boy who presented with a 64\u00b0 left proximal humeral varus angulation deformity and physeal bar secondary to multiple operations for a proximal humeral metaphyseal cystic lesion and pathologic fracture. Using a combined lateral closing and medial opening-wedge osteotomy, a 68\u00b0 valgus correction was achieved with excellent clinical and functional outcomes at 16-month follow-up. Forward flexion increased from 120 to 170\u00b0 preoperatively to postoperatively while abduction improved from 110\u00b0 preoperatively to 170\u00b0 postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A combined lateral closing and medial opening-wedge osteotomy of the proximal humerus can successfully treat cases of extreme proximal humerus varus in the growing shoulder where unilateral or dome osteotomies are not suitable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.23.00426","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T14:00:49Z","timestamp":1702044049000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Combined Lateral Closing and Medial Opening-Wedge Proximal Humerus Osteotomy in an Adolescent with Extreme Varus Deformity"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4562-4373","authenticated-orcid":false,"given":"Jacob F.","family":"Oeding","sequence":"first","affiliation":[{"name":"School of Medicine, Mayo Clinic Alix School of Medicine, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan J.","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7089-4343","authenticated-orcid":false,"given":"Adam J.","family":"Wentworth","sequence":"additional","affiliation":[{"name":"Anatomic Modeling Unit, Department of Radiology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0291-4634","authenticated-orcid":false,"given":"Stephen A.","family":"Sems","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony A.","family":"Stans","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2481-8064","authenticated-orcid":false,"given":"Jonathan D.","family":"Barlow","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,10]]},"reference":[{"issue":"116","key":"bib1-20240805","first-page":"158","article-title":"Developmental humerus varus","author":"Ogden","year":"1976","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib3-20240805","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1097\/BPO.0b013e318070cb69","article-title":"Corrective osteotomy for humerus varus","volume":"27","author":"Ugwonali","year":"2007","journal-title":"J Pediatr Orthop."},{"issue":"3","key":"bib4-20240805","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/S1058-2746(97)90021-5","article-title":"Valgus osteotomy of the humeral neck: a technique for the treatment of humerus varus","volume":"6","author":"Gill","year":"1997","journal-title":"J Shoulder Elbow Surg."},{"issue":"2","key":"bib5-20240805","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1302\/0301-620X.35B2.268","article-title":"Humerus varus; report of a case treated by excision of the acromion","volume":"35-B","author":"Lloyd-Roberts","year":"1953","journal-title":"J Bone Joint Surg Br."},{"issue":"2","key":"bib6-20240805","first-page":"367","article-title":"Humerus varus following birth injury to the proximal humeral epiphysis","volume":"29","author":"Lucas","year":"1947","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib7-20240805","first-page":"86","article-title":"Idiopathic humerus varus treated by osteotomy and progressive lengthening. A case report","volume":"52","author":"Verstreken","year":"1986","journal-title":"Acta Orthop Belg."},{"issue":"1","key":"bib8-20240805","doi-asserted-by":"crossref","first-page":"79","DOI":"10.3109\/17453678508992986","article-title":"Osteotomy of the neck of the humerus for traumatic varus deformity","volume":"56","author":"Solonen","year":"1985","journal-title":"Acta Orthop Scand."},{"issue":"4","key":"bib9-20240805","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1097\/01241398-199407000-00011","article-title":"Humerus varus: a complication of neonatal, infantile, and childhood injury and infection","volume":"14","author":"Ellefsen","year":"1994","journal-title":"J Pediatr Orthop."},{"issue":"268","key":"bib10-20240805","first-page":"235","article-title":"Growth plate activity in the upper extremity","author":"Pritchett","year":"1991","journal-title":"Clin Orthop Relat Res."},{"issue":"1","key":"bib11-20240805","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1097\/BPO.0000000000002289","article-title":"Supracondylar dome osteotomy with a posterior triceps-splitting approach for acute correction of posttraumatic cubital axis deformities in adolescent patients","volume":"43","author":"Herzog","year":"2023","journal-title":"J Pediatr Orthop."},{"issue":"3","key":"bib12-20240805","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1007\/s00402-021-04288-y","article-title":"Shortening dome osteotomy for correction of severe cubitus varus secondary to malunited supracondylar fractures in children","volume":"143","author":"Singh","year":"2023","journal-title":"Arch Orthop Trauma Surg."},{"issue":"3","key":"bib13-20240805","first-page":"RC08","article-title":"Management of cubitus varus deformity in children by closed dome osteotomy","volume":"11","author":"Verka","year":"2017","journal-title":"J Clin Diagn Res."},{"issue":"7","key":"bib14-20240805","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1097\/BPO.0000000000000366","article-title":"Valgus osteotomy of the proximal humerus to treat humerus varus in children","volume":"35","author":"Miao","year":"2015","journal-title":"J Pediatr Orthop."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.23.00426","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:41:42Z","timestamp":1787751702000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.23.00426"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":13,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.23.00426","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10]]}}}