CASE REPORT ON CUBITUS VARUS DEFORMITY AS A COMPLICATION OF UNITED MEDIAL CONDYLE OF HUMERUS FRACTURE- A RARE FRACTURE IN CHILDREN

Abstract Background Cubitus varus deformity (CVD), a common complication after a supracondylar fracture of the distal humerus, is usually treated with corrective osteotomy. However, due to the complex anatomy of the distal humerus, conventional osteotomy techniques are sometimes unreliable and can result in an inaccurate correction, residual deformity, and lateral condyle prominence. Recently, medial three-dimensional (3D) printing technology has demonstrated potential benefits for the treatment of CVD by improving the accuracy of the osteotomy through the use of an osteotomy guide with or without a patient-mated plate. This study aimed to present an interesting CVD case involving a patient who was treated with corrective biplanar Chevron osteotomy using an innovative customized osteotomy guide and a newly designed patient-matched monoblock crosslink plate created with 3D printing technology. Methods A computer simulation was processed using images from computerized tomography(CT) scans of both upper extremities. The biplanar Chevron osteotomy was designed to create identical anatomy between the mirror image of the contralateral distal humerus and the osteotomized distal humerus. Next, the customized osteotomy guide and patient-matched monoblock crosslink plate were designed and printed. A simulation osteotomy for the real-sized bone model was created. Results The operation was performed using the posterior paratricipital approach and the k-wire position from the customized osteotomy guide as a predrilled hole for screw fixation to achieve immediate control of the reduction after osteotomy. Our method helped successfully treat the CVD in the case study patient and significantly improved her radiographic and clinical outcomes with a satisfactory result. Conclusion This study showed that the treatment of CVD using 3D printing technology to create an innovative customized osteotomy guide and a patient-matched monoblock crosslink plate can help accurately assess and control the CVD correction. To the best of our knowledge, this case report introduces a new insight for the clinical application of 3D printing technology in the treatment of CVD.

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The lateral curved osteotomy for cubitus varus deformity in children: A case report and literature review

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2021.102315 ◽

2021 ◽

pp. 102315

Author(s):

Iman Solichin ◽

Gede Sandjaya ◽

Nurmansyah Hata Dwi Putra ◽

Ido Prabowo ◽

Sholahuddin Rhatomy

Keyword(s):

Case Report ◽

Literature Review ◽

Varus Deformity ◽

Cubitus Varus

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Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1403-7 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 3

Author(s):

Yuan-Wei Zhang ◽

Xin Xiao ◽

Wen-Cheng Gao ◽

Yan Xiao ◽

Su-Li Zhang ◽

...

Keyword(s):

3D Printing ◽

Blood Loss ◽

Three Dimensional ◽

Operation Time ◽

Varus Deformity ◽

Conventional Group ◽

Intraoperative Blood Loss ◽

Cubitus Varus ◽

Guide Plate ◽

Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

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An Innovative and Cost-Advantage CAD Solution for Cubitus Varus Surgical Planning in Children

Applied Sciences ◽

10.3390/app11094057 ◽

2021 ◽

Vol 11 (9) ◽

pp. 4057

Author(s):

Leonardo Frizziero ◽

Gian Maria Santi ◽

Christian Leon-Cardenas ◽

Giampiero Donnici ◽

Alfredo Liverani ◽

...

Keyword(s):

Computer Aided Design ◽

Low Cost ◽

Cost Effective ◽

Varus Deformity ◽

Patient Specific ◽

Cubitus Varus ◽

Surgical Guide ◽

Traditional Procedure ◽

Custom Made ◽

Patient Specific Instruments

The study of CAD (computer aided design) modeling, design and manufacturing techniques has undergone a rapid growth over the past decades. In medicine, this development mainly concerned the dental and maxillofacial sectors. Significant progress has also been made in orthopedics with pre-operative CAD simulations, printing of bone models and production of patient-specific instruments. However, the traditional procedure that formulates the surgical plan based exclusively on two-dimensional images and interventions performed without the aid of specific instruments for the patient and is currently the most used surgical technique. The production of custom-made tools for the patient, in fact, is often expensive and its use is limited to a few hospitals. The purpose of this study is to show an innovative and cost-effective procedure aimed at prototyping a custom-made surgical guide for address the cubitus varus deformity on a pediatric patient. The cutting guides were obtained through an additive manufacturing process that starts from the 3D digital model of the patient’s bone and allows to design specific models using Creo Parametric. The result is a tool that adheres perfectly to the patient’s bone and guides the surgeon during the osteotomy procedure. The low cost of the methodology described makes it worth noticing by any health institution.

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