A Simple Dual-Planar Osteotomy to Correct Cubitus Varus Deformity in Children

Liddell, Travis R.; Hennrikus, William L.; Bresnahan, James J.

doi:10.1097/bot.0000000000000591

Cited by 14 publications

(19 citation statements)

References 50 publications

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“…Scholars increasingly believe that the cubitus varus deformity is a 3D deformity, including varus deformity of the coronal plane, overextension deformity of the sagittal plane, and internal rotation deformity of the horizontal plane [5]. This poses a challenge for orthopedic surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…Cubitus varus deformity is a common sequela of elbow fractures in children [1][2][3][4]. Although the cause of cubitus varus deformity remains inconclusive, it is considered a three-dimensional (3D) deformity including varus deformity of the coronal plane, an overextension deformity of the sagittal plane, and an internal rotation deformity of the horizontal plane [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

Hu¹,

Zhong²,

Lou

et al. 2020

J Orthop Surg Res

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Background: Cubitus varus deformity is a common sequela of elbow fractures in children. Cubitus varus deformity treatment is tending toward 3D correction, which is challenging for orthopedic surgeons. This study aims to explore whether individualized 3D-printed navigation templates can assist with accurate and effective corrective treatment of children with cubitus varus deformity. Methods: Thirty-five patients were treated for cubitus varus deformity from June 2015 to April 2017, including 21 boys and 14 girls, aged 4.6-13.2 years (average, 7.5 years). Of these cases, 17 deformities were on the left side and 18 were on the right side. All were treated with wedge osteotomy of the lateral distal humerus. 3D-printed navigation templates were used in 16 cases, while traditional surgery was used in 19 cases. All patients underwent computed tomography scans before surgery. Computer software was used to analyze the measurements and design and print individualized navigation templates. The navigation templates were matched, and surgery was initially simulated. Intraoperative individualized navigation templates were used to assist with accurate osteotomy and Kirschner wire fixation. Operation times were recorded in all cases, the carrying angles before and after surgery were assessed by computer, and postoperative elbow joint function was evaluated using Bellemore criteria. All measurement data were presented as means ± SD, and Student's t test was used to examine differences between groups. All count data between both groups were compared using the chi-square test or Fisher's exact test analysis. Results: All individualized navigation templates matched well with the corresponding anatomical markers and were consistent with preoperative planning, simulated surgery, and intraoperative procedures. Average operation times from clear exposure to fixed Kirschner wire were 11.69 min (9.6-13.5 min) for the individualized navigation template group and 22.89 min (17.7-26.8 min) for the traditional operation group (p < 0.001). Average differences in postoperation carrying angles between affected and healthy sides were 1.13°(0-2.0°) and 4.21°(0-7.5°), respectively (p < 0.001). Follow-up 6-12 months postoperation showed that elbow function did not differ significantly between groups using the Bellemore criteria (p > 0.05). Conclusions: Individualized navigation templates simplify procedures, reduce operation time, and improve accuracy when used in orthopedic surgery to treat children with cubitus varus deformity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

Hu¹,

Zhong²,

Lou

et al. 2020

J Orthop Surg Res

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“…Distal humeral fracture is the most usual upper limb fracture in adolescents, with an incidence of about 60% in all elbow fractures [1]. Cubitus varus deformity, as the most common complication of the distal humeral fractures in adolescents, accounts for approximately 30% to 58% [2, 3]. In addition to the varus on the coronal plane, the cubitus varus can also include the three-plane deformities of the overextension on the sagittal plane and the internal rotation on the horizontal plane [4].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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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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“… Approach of the elbow: Lateral [ 12 , 13 , [15] , [16] , [17] ], posterolateral [ 10 , 18 ], posterior (triceps splitting) [ 3 , [19] , [20] , [21] ], and posterior approach with Chevron's osteotomy [ 19 ]. The configuration of osteotomy was described by many literatures, that bear various names on its techniques: French [ 5 , 22 , 23 ], Dome-shaped [ 10 , 19 , 21 , 24 ], Pentalateral [ 16 ], translation step cut [ 3 ], modified step cut [ 2 ], triple modified French [ 12 ], reverse V [ 20 ], dual planar [ 25 ], and multiplanar [ 17 ], lateral closing isosceles triangular [ 15 ], three-dimensional printing assisted [ 26 ], and oblique lateral closing-wedge [ 13 ]. They mostly provide similar advantages but with different outcome evaluations.…”

Section: Literature Review and Discussionmentioning

confidence: 99%

“…The comparison of these surgical techniques is often described equally, reporting similar good results with several advantages and disadvantages [ 4 , 17 ]. Fixation technique: Cortical screw then tension band wire [ 5 , 12 , 18 ], K-Wire only [ 2 , 10 , 13 , 18 , 21 , 24 , 27 ], single Y plate [ 3 , 20 ], K-wire then lag screw parallel [ 16 ], buried smooth K-wire [ 25 ], two lateral K-wire [ 15 ], and 3D printing osteotomy guide plate [ 26 ]. …”

Section: Literature Review and Discussionmentioning

confidence: 99%

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

Solichin

Sandjaya

Prabowo

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction Cubitus varus deformity after malunited supracondylar humerus fracture has various surgical techniques, implant configurations, and approaches. We describe a combination of French and Dome osteotomy and novel internal fixation technique to deliver an easy, safe, fast and reproducible result based on the current best evidence. Presentation of case Two cases of malunited supracondylar humerus are described. The first case involves a 3-year-old girl who presented with outstretched and supinated left arm after falling during bike riding 3 weeks earlier. We found no abnormality in radial and median nerve function, but the left arm radiographs showed a callus formation and the early stages of a malunited fracture of the supracondylar humerus. We waited two months for further radiographic evaluation and the radiographs showed the malunited supracondylar humerus with elbow flexion of only 105° and elbow hyperextension of 20°. The cubitus varus was recorded with clinical carrying angle of varus 10°. We used a combination of original French and Dome osteotomy, lateral approach, and our novel fixation technique with excellent results. The second case involved a 8-year-old boy with malunited right elbow and the surgery was done in the same manner, with the result of restoration to normal elbow range of motion. We also assessed the pain score and disabilities of the arm, shoulder and hand (DASH) score and recorded satisfactory results. Conclusions The combination of French and Dome osteotomy for treatment of cubitus varus deformity can provide an easy, safe, and reproducible result.

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A Simple Dual-Planar Osteotomy to Correct Cubitus Varus Deformity in Children

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 14 publications

References 50 publications

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

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

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

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