Three-Dimensional Corrective Osteotomy for Cubitus Varus Deformity with Use of Custom-Made Surgical Guides.

INTRODUCTION

We present a detailed description of our preoperative planning and surgical technique for three-dimensional (3-D) corrective osteotomy with use of custom-made surgical guides for cubitus varus deformity after supracondylar fracture.

STEP 1 CREATE COMPUTER BONE MODELS FROM CT DATA: Obtain CT data of both upper extremities and create computer bone models from these data.

STEP 2 EVALUATE THE 3-D DEFORMITY: Evaluate the deformity in three dimensions by comparing the affected humerus with the mirror image of the contralateral, normal humerus.

STEP 3 PLAN THE 3-D CORRECTIVE OSTEOTOMY: Simulate a 3-D corrective osteotomy on the basis of information obtained from the deformity evaluation.

STEP 4 OPERATIVE SETUP: Order the custom-made surgical guides that will assist you in reproducing the preoperative simulation during the actual surgery.

STEP 5 PERFORM THE 3-D OSTEOTOMY USING THE CUSTOM-MADE SURGICAL GUIDES: Perform the osteotomy using the custom-made surgical guides and achieve anatomical correction using the reduction guides.

STEP 6 POSTOPERATIVE CARE: Apply a removable splint and have the patient start active and passive range-of-motion exercise after the splinting period has been completed.

RESULTS

In our series of thirty patients, the mean humerus-elbow-wrist angle and tilting angle of the affected side were 18° (varus) and 25°, respectively, before surgery, which significantly improved to 6° (valgus) and 38°, respectively, after surgery.IndicationsContraindicationsPitfalls & Challenges.