Efficacy of 3D-printed surgical guides in the correction of pediatric cubitus varus deformity: a systematic review and meta-analysis

IF 2 Q2 Medicine

JSES International Pub Date : 2026-03-01 Epub Date: 2025-12-23 DOI:10.1016/j.jseint.2025.101604

Omid Salkhori MD , Nima Bagheri MD , Seyyed Saeed Khabiri MD , Aidin Arabzadeh MD , Seyyed Hadi Kalantar MD , Elham Poorghasem MD , Pouya Tabatabei Irani MD , Alireza Talebi MD , Seyed Mohammadjavad Mortazavi MD , Hamed Naghizadeh MD

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Abstract

Background

Cubitus varus is a frequent post-traumatic deformity in children, typically resulting from malunion of supracondylar humeral fractures. Despite the availability of various osteotomy techniques, achieving precise and reproducible correction remains challenging. Recently, 3-dimensional (3D) printing–guided osteotomy has gained attention for improving surgical accuracy and outcomes. This study aimed to systematically evaluate the clinical effectiveness and safety of 3D-guided corrective osteotomy in pediatric cubitus varus in comparison with conventional surgical techniques.

Methods

We performed a systematic review and meta-analysis of studies published between 2000 and 2025 that investigated the use of 3D printing–assisted, patient-specific instrumentation in corrective osteotomy for pediatric cubitus varus. Databases searched included PubMed, Scopus, and Web of Science. Both single-arm and comparative studies reporting clinical, radiographic, and operative outcomes were included. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORs) criteria.

Results

Twelve studies involving 206 pediatric patients were included, comprising 2 prospective and 10 retrospective studies. In the single-arm meta-analysis, 81.9% of patients achieved excellent outcomes, with a pooled complication rate of 7.8%. A comparative analysis revealed a significantly higher likelihood of excellent outcomes in the 3D group compared to conventional techniques (risk ratio = 1.33; 95% confidence interval: 1.05-1.69), while complication rates and humerus–elbow–wrist angle correction were similar between the groups.

Conclusion

3D printing–guided corrective osteotomy appears to offer high success rates and low complication rates in treating pediatric cubitus varus, with potential advantages over conventional techniques. Further prospective studies are needed to confirm these findings and guide clinical adoption.

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3d打印手术指南在小儿肘内翻畸形矫正中的疗效：系统回顾和荟萃分析。

背景：儿童肘内翻是一种常见的创伤后畸形，通常由肱骨髁上骨折不愈合引起。尽管有各种截骨技术，但实现精确和可重复的矫正仍然具有挑战性。最近，三维（3D）打印引导截骨术因其提高手术精度和疗效而受到关注。本研究旨在系统评价3d引导下小儿肘内翻矫正截骨术与常规手术方法的临床疗效和安全性。方法：我们对2000年至2025年间发表的研究进行了系统回顾和荟萃分析，这些研究调查了3D打印辅助的患者特定器械在小儿肘内翻矫正截骨术中的应用。搜索的数据库包括PubMed、Scopus和Web of Science。单臂研究和比较研究均报告了临床、放射学和手术结果。方法学质量采用非随机研究方法学指数（minor）标准进行评估。结果：纳入12项研究，涉及206例儿科患者，其中2项为前瞻性研究，10项为回顾性研究。在单臂荟萃分析中，81.9%的患者获得了良好的结果，合并并发症发生率为7.8%。对比分析显示，与传统技术相比，3D组获得良好结果的可能性明显更高（风险比= 1.33；95%可信区间：1.05-1.69），而两组之间的并发症发生率和肱骨-肘关节-腕关节角度矫正相似。结论：3D打印引导下矫形截骨术治疗小儿肘内翻成功率高，并发症发生率低，与传统技术相比具有潜在优势。需要进一步的前瞻性研究来证实这些发现并指导临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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