gms | German Medical Science

Objectives: The treatment of adult cubitus varus deformity is mainly based on humeral supracondylar osteotomy correction. The main surgical methods include lateral closed wedge osteotomy, triangular osteotomy, and V-shaped osteotomy, all of which have problems such as instability after osteotomy, loss of correction angle, and residual deformity due to insufficient osteotomy. Especially for patients with severe cubitus varus deformity, the therapeutic effect is not satisfactory. This article aims to analyze the application value of 3D printing technology assisted dome shaped osteotomy in the correction of severe cubitus varus deformity.

Methods: Collect 12 adult patients with cubitus varus deformity admitted to our hospital from April 2020 to April 2023. There are 7 males and 5 females, aged 19–30 years, with an average age of 24.5 years. There are 4 cases on the left and 6 cases on the right. The preoperative X-ray measurement showed that the lifting angle of the affected elbow joint was (-23.2 ± 3.3) °, and the forward inclination angle was (-10.5 ± 2.3) °. Elbow joint extension (-10.0 ± 2.5) ° and flexion (127.3 ± 7.3) °. Before surgery, 3D reconstruction of the elbow joint was performed based on CT scan data. 3D printing was used to output the elbow joint model in a 1:1 ratio. Preoperative rehearsals were performed to simulate the site of osteotomy, osteotomy angle, osteotomy quantity calculation, as well as the selection, shaping, and placement of bone plates. The normal anatomical angle of the elbow joint was restored, and the optimal osteotomy angle was planned. With its assistance, orthopedic surgery was completed. Postoperative X-ray re examination was performed to measure the elbow joint lifting angle and forward tilt angle, Observe the range of motion of the elbow joint in flexion and extension. One year after surgery, elbow joint function was evaluated according to the Oppenheim elbow joint function scoring standard and imaging examination was performed.

Results and conclusion: The surgeries were successfully completed with the assistance of 3D printing. Postoperative incisions all healed in stage I. All patients were followed up for 12–18 months, with an average of 15 months. The X-ray shows that all osteotomy sites have achieved bone healing, with a healing time of 9–12 weeks, with an average of 11 weeks. One year after surgery, the lifting angle of the affected elbow joint was (9.7 ± 1.9) °, the anteversion angle was (20.7 ± 4.3) °, and the elbow joint extended to (2.6 ± 3.5) ° and flexed to (139.2 ± 4.8) °, all of which were significantly increased compared to before surgery (P<0.05). One year after surgery, 9 cases were excellent and 3 cases were good according to the Oppenheim elbow joint function scoring standard. During the follow-up period, there were no postoperative infections, neurovascular injuries, loosening or rupture of internal fixation, and no recurrence of cubitus varus.