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.
Pitfalls & Challenges
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 humerus1-3. Three-dimensional corrective osteotomy has been advocated by the authors of several studies to improve cosmetic appearance and to reconstruct the physiological joint motion …
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