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

 

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. Cubitus varus deformity after supracondylar fracture includes not only varus but also extension and internal rotation deformities of the distal part of the humerus. Three-dimensional corrective osteotomy has been advocated by the authors of several studies to improve cosmetic appearance and to reconstruct the physiological joint motion around the elbow joint. However, the shortcomings of conventional 3-D osteotomies include difficulty in accurately planning and performing the surgery and in providing rigid internal fixation with a relatively small contact area at the osteotomy site after rotational correction. The postoperative loss of correction and a relatively high rate of complications are also of concern. We developed a computer simulation system that enabled surgeons to precisely evaluate a deformity. It also enabled the simulation of 3-D corrective osteotomy with use of computer models constructed from computed tomography (CT) data and the design of a custom-made surgical guide to assist in reproducing the preoperative simulation during the actual surgery. The drawbacks of conventional 3-D osteotomy for cubitus varus deformity can be eliminated by this novel technique.