Three-dimensional printing technology for patient-matched instrument in treatment of cubitus varus deformity: A case report

Figure 1 Preoperative evaluation. A: Clinical pictures showing the cubitus varus and hypertension deformity of the left elbow; B: Preoperative radiographs in antero-posterior and lateral views showing a humerus-elbow-wrist angle of 15º varus and a shaft condylar angles of 35º on the left side, and those of 13º valgus and 45º, respectively; C: Three-dimensional computed tomography analysis with overlapping of the mirror image model from the right humerus (green color) and the deformed model from the left humerus (blue color). Anterior view showing a 15º-degree varus deformity. Lateral view showing a 10º-degree hyperextension deformity. Axial view showing no rotational deformity.

Figure 2 Preparation of the customized osteotomy guide and patient-matched plate. A: The biplanar chevron osteotomy was designed, and the osteotomy block in antero-posterior and lateral views from medial (*) and lateral (^#) were demonstrated; B: The proximal, osteotomized, and distal fragments are shown in light green, yellow, and dark blue color respectively. The customized osteotomy guide was designed and printed accordingly; C: The patient-matched monoblock crosslink plate was innovated and made by using the same holes for k-wire and screw fixation; D: Intraoperative surgical steps for the customized osteotomy guide placement, osteotomy, and fixation respectively with the patient-matched implant; E: Intraoperative fluoroscopic images after fixation.

Figure 3 Postoperative radiographic and clinical outcomes. A and B: The 3-mo postoperative radiographs of both elbows in antero-posterior (A) and lateral (B) views showing nearly anatomical alignment of the left elbow compared with the right elbow; C-E: The 3-mo postoperative clinical examination revealed nearly identical alignment of both elbows (C), with the same flexion/extension (D) and pronation/supination range of motion (E).