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

Abstract

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. Obtain CT data of both upper extremities and create computer bone models from these data. Evaluate the deformity in three dimensions by comparing the affected humerus with the mirror image of the contralateral, normal humerus. Simulate a 3-D corrective osteotomy on the basis of information obtained from the deformity evaluation. Order the custom-made surgical guides that will assist you in reproducing the preoperative simulation during the actual surgery. Perform the osteotomy using the custom-made surgical guides and achieve anatomical correction using the reduction guides. Apply a removable splint and have the patient start active and passive range-of-motion exercise after the splinting period has been completed. 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.