Sri-utenchai N, Pengrung N, Srikong K, Puncreobutr C, Lohwongwatana B, Sa-ngasoongsong P. Three-dimensional printing technology for patient-matched instrument in treatment of cubitus varus deformity: A case report. World J Orthop 2021; 12(5): 338-345 [PMID: 34055591 DOI: 10.5312/wjo.v12.i5.338]
Corresponding Author of This Article
Paphon Sa-ngasoongsong, MCh, MD, Associate Professor, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand. paphonortho@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nithid Sri-utenchai, Nachapan Pengrung, Paphon Sa-ngasoongsong, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
Korakod Srikong, Biomechanic Research Center, Meticuly Co Ltd., Chulalongkorn University, Bangkok 10330, Thailand
Chedtha Puncreobutr, Boonrat Lohwongwatana, Department of Metallurgical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
Author contributions: Sri-utenchai N and Sa-ngasoongsong P were the main researchers who conceptualized and performed the study, and prepared the manuscript; Pengrung N was the orthopedic surgeon who assisted in the data collection; Srikong K, Puncreobutr C, and Lohwongwatana B were the experienced engineer team who performed the computer simulation and assisted in the customized osteotomy guide and patient-matched monoblock crosslink plate design and manufacture; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of her anonymized information to be published in this article.
Conflict-of-interest statement: All of the authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Paphon Sa-ngasoongsong, MCh, MD, Associate Professor, Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand. paphonortho@gmail.com
Received: March 5, 2021 Peer-review started: March 5, 2021 First decision: March 31, 2021 Revised: April 12, 2021 Accepted: April 23, 2021 Article in press: April 23, 2021 Published online: May 18, 2021 Processing time: 68 Days and 5.6 Hours
Abstract
BACKGROUND
Recently, medical three-dimensional printing technology (3DPT) has demonstrated potential benefits for the treatment of cubitus varus deformity (CVD) by improving accuracy of the osteotomy through the use of an osteotomy guide, with or without a patient-mated plate. Here, we present an interesting CVD case, involving a patient who was treated with corrective biplanar chevron osteotomy using an innovative customized osteotomy guide and a newly designed patient-matched monoblock crosslink plate created with 3DPT.
CASE SUMMARY
A 32-year-old female presented with a significant CVD from childhood injury. A computer simulation was processed using images from computerized tomography scans of both upper extremities. The biplanar chevron osteotomy was designed to create identical anatomy between the mirror image of the contralateral distal humerus and the osteotomized distal humerus. Next, the customized osteotomy guide and patient-matched monoblock crosslink plate were designed and printed. A simulation osteotomy was created for the real-sized bone model, and the operation was performed using the posterior paratricipital approach with k-wire positioning from the customized osteotomy guide as a predrilled hole for screw fixation to achieve immediate control of the reduction after osteotomy. Our method allowed for successful treatment of the CVD case, significantly improving the patient’s radiographic and clinical outcomes, with satisfactory result.
CONCLUSION
3DPT-created patient-matched osteotomy guide and instrumentation provides accurate control during CVD correction.
Core Tip: To the best of our knowledge, this case report introduces a new insight for the clinical application of three-dimensional printing technology in the treatment of cubitus varus deformity. Successful outcome of cubitus varus deformity correction is dependent upon precise preoperative planning and the accuracy of osteotomy and fixation. The treatment procedure itself can be performed safely, with high chance of alignment correction by means of three-dimensional printing technology to generate a well-designed customized osteotomy guide and patient-matched plate.
