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

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.