Three-Dimensional Correction of Cubitus Varus Deformity Using Patient-Specific 3D-Printed Osteotomy Guides

Background : Various three-dimensional (3D) corrective osteotomy techniques have been reported for the treatment of cubitus varus deformity. However, achieving accurate correction through a minimally invasive incision remains technically challenging. This study introduces a method for accurate 3D osteotomy of cubitus varus deformity using a minimally invasive lateral incision. Methods : Five patients (2 males and 3 females) with cubitus varus deformity following supracondylar fracture underwent 3D corrective osteotomy using 3D-printed, patient-specific osteotomy templates, along with custom location and reduction guides, between August 2022 and January 2025. These cases were evaluated retrospectively. Clinical outcomes assessed included pre- and postoperative carrying angles, operative time, elbow joint function, intraoperative blood loss, degree of osteotomy, time to bone union, and postoperative complications. Results : The mean carrying angle on the affected side improved significantly from − 15.74° ± 6.58° (varus) preoperatively to 7.77° ± 3.94° (valgus) postoperatively. The mean tilting angle improved from 54.8° ± 7.40° to 51.4° ± 2.33°. Elbow range of motion normalized in all patients, with a mean increase in flexion angle of 24° ± 8° (range: 15°–35°). Hyperextension of the elbow and internal rotation of the shoulder were also corrected. Bone union was achieved at a mean of 2.6 ± 0.49 months (range: 2–3 months). The average operative time was 139.6 ± 22.26 minutes (range: 116–175 minutes), and mean intraoperative blood loss was 42 ± 31.87 mL (range: 10–100 mL). The mean correction angle achieved through osteotomy was 23.51° ± 8.79° (range: 12.43°–33.43°). According to the Mayo Elbow Performance Index (MEPI), all five patients achieved excellent outcomes at the final follow-up (mean: 21.6 ± 4.8 months), with no reports of poor results, recurrence of varus deformity, or wound-related complications. One patient exhibited transient ulnar nerve symptoms postoperatively. No patients reported prominence of the lateral humerus. Conclusion : The use of a 3D-printed, patient-specific osteotomy guide combined with custom location and reduction templates enables safe, accurate, and reproducible 3D correction of cubitus varus deformity through a minimally invasive lateral incision. This surgical technique, grounded in 3D computer simulation, reduces variability between surgeons and may represent a viable therapeutic option for the correction of cubitus varus deformity.