Single-Stage Double-Level Osteotomy for Complex Cubitus Varus Involving the Humerus and Ulna

Case: A 15-year-old male baseball pitcher presented with progressive cubitus varus deformity after multiple childhood elbow fractures treated conservatively. Three-dimensional evaluation demonstrated multiplanar deformities involving both the humerus and ulna. A single-stage double-level osteotomy was performed using patient-specific cutting guides and custom-made plates. Postoperatively, alignment was restored, bone union was achieved without complications, and the patient returned to competitive sport at 5 months, remaining asymptomatic at 36 months of follow-up. Conclusion: Complex cubitus varus involving multiple skeletal segments may not be correctable with single-level osteotomy. Double-level osteotomy allows anatomical realignment while preserving elbow joint orientation, reliably achieved using three-dimensional patient-specific techniques.