Tsuyoshi Murase1, Yukari Takeyasu1, Kunihiro Oka1, Toshiyuki Kataoka1, Hiroyuki Tanaka1, Hideki Yoshikawa1. 1. Department 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.
Abstract
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.
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.