Forearm malunion affects upper limb function, impairing rotation, grip strength, and dexterity. Traditional osteotomies, based on two-dimensional imaging and intraoperative adjustments, may fail to address the intricate three-dimensional aspects of forearm deformities. Advances in 3D technology, including imaging, virtual surgical planning and 3D-printed patient-specific guides, have transformed corrective osteotomy by enhancing precision and predictability. This paper discusses the limitations of traditional methods, the role of 3D imaging in detailed deformity analysis, the benefits of virtual planning and the use of 3D surgical guides to improve outcomes. The use of 3D technology in both paediatric and adult cases is illustrated in a supplementary series of case reports. Future improvements in artificial intelligence, robotics and augmented reality are expected to enhance 3D-guided osteotomies further, making them more accessible and cost-effective.
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