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

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Background Cubitus varus deformity is a common complication following supracondylar fractures of the humeri in children. Due to the limited capacity of the distal humeral epiphysis to spontaneously correct existing varus deformity, the deformity typically persists into adulthood without improvement. Accurate correction of this deformity is essential to prevent late complications and significantly improve cosmetic appearance. However, achieving precise correction through a limited incision remains technically emanding. Case presentation We present the case of a 12-year-old female who sustained a left supracondylar humeral fracture following a fall at the age of 11 years. The patient was initially treated with immobilization cast at another hospital. Four weeks after cast removal, a cubitus varus deformity was noted, which persisted for 8 months following the initial injury. The patient was subsequently to our hospital for improvement of both function and cosmesis. A three-dimensional (3D) guided accurate osteotomy was performed using a custom-made surgical template combined with a reduction template via a limited lateral incision. The operation time was 116 min, with an intraoperative blood loss of 20 mL. Postoperatively, 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. Bone union was achieved at 3 months after surgery. At the 1-year follow-up, the patient had an excellent outcome with a Hospital for Special Surgery score of 98, and without recurrence of 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.