Abstract
BackgroundCubitus 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.MethodsThirty-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.ResultsAll 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).ConclusionsIndividualized navigation templates simplify procedures, reduce operation time, and improve accuracy when used in orthopedic surgery to treat children with cubitus varus deformity.
Highlights
Cubitus varus deformity is a common sequela of elbow fractures in children
Some researchers think that the biomechanical axis disruption includes internal rotation deformity, which leads to soft tissue and morphologic bony alterations in the elbow and offers a compelling argument for corrective osteotomy to treat pediatric cubitus varus [10,11,12,13]
This study aimed to explore whether individualized 3D-printed navigation templates can assist with accurate and effective corrective treatment of children with cubitus varus deformity
Summary
Cubitus varus deformity treatment is tending toward 3D correction, which is challenging for orthopedic surgeons. Most orthopedic surgeons only performed humeral supracondylar valgus osteotomy to treat cubitus varus deformity [1, 7], believing that the rotational deformity of the horizontal plane did not need to be corrected owing to shoulder joint compensation [8, 9]. Some researchers think that the biomechanical axis disruption includes internal rotation deformity, which leads to soft tissue and morphologic bony alterations in the elbow and offers a compelling argument for corrective osteotomy to treat pediatric cubitus varus [10,11,12,13]. Lateral wedge osteotomies are performed most commonly [2]. The main drawback of lateral wedge osteotomy is the prominence of the lateral condyle and the asymmetry of the two osteotomy surfaces, which might result in a step at the end of the osteotomy
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
