Computer aided multiplanar osteotomy using patient specific instrumentation to treat cubitus varus in children

Estelle Alonso; Christian Victoria; Nizar Touati; Raphael Vialle; Franck Fitoussi; Manon Bachy

doi:10.1016/j.otsr.2023.103808

Computer aided multiplanar osteotomy using patient specific instrumentation to treat cubitus varus in children

Orthop Traumatol Surg Res. 2023 Dec 29:103808. doi: 10.1016/j.otsr.2023.103808. Online ahead of print.

Authors

Estelle Alonso¹, Christian Victoria², Nizar Touati¹, Raphael Vialle¹, Franck Fitoussi³, Manon Bachy⁴

Affiliations

¹ Service de chirurgie orthopédique et réparatrice de l'enfant, Sorbonne Université, AP-HP, Hôpital Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France.
² Hospital for Special Surgery, Hand and Upper Extremity Service, New York, NY, USA.
³ Service de chirurgie orthopédique et réparatrice de l'enfant, Sorbonne Université, AP-HP, Hôpital Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France; STREAM, CRMR Site Trousseau enfant anomalie des membres, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France.
⁴ Service de chirurgie orthopédique et réparatrice de l'enfant, Sorbonne Université, AP-HP, Hôpital Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France; STREAM, CRMR Site Trousseau enfant anomalie des membres, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France; UMR CNRS 7052, Inserm U1271, Université de Paris, B3OA, 10, avenue de Verdun, 75010 Paris, France. Electronic address: manon.bachy@aphp.fr.

PMID: 38159639
DOI: 10.1016/j.otsr.2023.103808

Abstract

Cubitus varus deformity is a common complication of supracondylar fractures in children. Anatomic correction is the key to obtaining good functional results and avoiding later symptomatic degradation. Different techniques have been described, mainly lateral closing wedge osteotomy. A medial opening wedge osteotomy seems more intuitive, allowing an anatomic reduction, but it is technically challenging. Two-plane radiographs are too simplistic to appreciate the 3D deformity. With medical imaging and image processing advances, three-dimensional (3D) virtual models of a patient's anatomy can be generated. Rapid 3D printing has allowed virtual simulations of surgical corrections to be transferred to real-world applications in the operating room, allowing more precise and accurate surgery with better 3D corrections. 3D computer modeling with the development of customized drilling and cutting guides allows complex medial opening wedge osteotomy for correction of cubitus varus deformity in immature children with best-fit plate synthesis. LEVEL OF EVIDENCE: IV.

Keywords: Children; Cubitus varus; Osteotomy; Patient specific instrumentation.