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Three-Dimensional Corrective Osteotomy for Cubitus Varus Deformity with Use of Custom-Made Surgical Guides
Tsuyoshi Murase1, Yukari Takeyasu1, Kunihiro Oka1
1Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Osaka, Japan. E-mail address for T. Murase: tmurase-osk@umin.net. E-mail address for Y. Takeyasu: torikarin24@gmail.com. E-mail address for K. Oka: oka-kunihiro@umin.ac.jp. E-mail address for T. Kataoka: kataoka@qk9.so-net.ne.jp. E-mail address for H. Tanaka: tanahiro-osk@umin.ac.jp. E-mail address for H.Yoshikawa: yhideki@ort.med.osaka-u.ac.jp.
Introduction:
We present a detailed description of our preoperative planning and surgical technique for three-dimensional (3-D) corrective osteotomy with use of custom-made surgical guides for cubitus varus deformity after supracondylar fracture.
Step 1 Create Computer Bone Models From Ct Data:
Obtain CT data of both upper extremities and create computer bone models from these data.
Step 2 Evaluate The 3-D Deformity:
Evaluate the deformity in three dimensions by comparing the affected humerus with the mirror image of the contralateral, normal humerus.
Step 3 Plan The 3-D Corrective Osteotomy:
Simulate a 3-D corrective osteotomy on the basis of information obtained from the deformity evaluation.
Step 4 Operative Setup:
Order the custom-made surgical guides that will assist you in reproducing the preoperative simulation during the actual surgery.
Step 5 Perform The 3-D Osteotomy Using The Custom-Made Surgical Guides:
Perform the osteotomy using the custom-made surgical guides and achieve anatomical correction using the reduction guides.
Step 6 Postoperative Care:
Apply a removable splint and have the patient start active and passive range-of-motion exercise after the splinting period has been completed.
Results:
In our series of thirty patients, the mean humerus-elbow-wrist angle and tilting angle of the affected side were 18° (varus) and 25°, respectively, before surgery, which significantly improved to 6° (valgus) and 38°, respectively, after surgery.IndicationsContraindicationsPitfalls & Challenges.
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