3D Accurate Osteotomy for Pediatric Cubitus Varus Deformity using a Custom-Matched Surgical Osteotomy Template Combined with a Reduction Template via a Limited Lateral Incision: A Case Report and Literature Review

Cubitus varus deformity is a common complication following a supracondylar fracture of the humerus in children. Due to the limited capacity of the distal humeral epiphysis to spontaneously correct existing varus deformity, this condition typically persists into adulthood without improvement. Accurate correction of this deformity is essential to prevent late sequelae and significantly enhance cosmetic appearance. However, achieving precise correction through a limited incision is technically challenging.Case Presentation:We present the case of a 12-year-old female who sustained a supracondylar fracture of the left humerus after a fall when she was 11 years old. The patient was initially treated with an immobilization cast at another hospital. Four weeks after cast removal, a cubitus varus deformity was noted, and it persisted for 8 months following the initial injury. The patient was then referred to our hospital seeking complete functional and cosmetic improvement. The patient underwent a three-dimensional (3D) accurate osteotomy using a custom-made surgical template combined with a reduction template via a limited lateral incision. The operation time was 116 minutes, with an intraoperative blood loss of 20 mL. The carrying angle and tilting angle on the affected side improved significantly from − 22.1° (varus) and 1.3° preoperatively to 12.2° (valgus) and 52.3°, respectively, postoperatively. Bone union was achieved at 3 months after surgery. At the one-year follow-up, the patient had an excellent outcome with a Hospital for Special Surgery score of 98, and without recurrence of the varus deformity, neurovascular injury, or wound complications.Conclusion:Accurate 3D correction of pediatric cubitus varus deformity can be successfully achieved using a custom-matched surgical osteotomy template combined with a reduction template via a limited lateral incision.