gms | German Medical Science

Objectives/Interrogation: Scaphoid fractures are the most common fractures of the wrist, with a high clinical incidence. The fracture line without dislocation is often not obvious in X-ray image at the initial stage, which causes a high misdiagnosed risk, and leads to scaphoid nonunion. The commonly used clinical treatment is open reduction and internal fixation with bone graft. However, open surgery, due to certain damage to blood supply, might affect the healing rate. The development of wrist arthroscopy has transformed many wrist diseases from open surgery to minimally invasive surgery. The application of 3D printing guiding plate technology has made the operation of clinical surgery more precise and further reduced the surgical related trauma. In our previous paper, 3D printing was applied to treat acute scaphoid fracture. In this paper, we introduced the using 3D printing assisted technique and results for patients with scaphoid nonunion.

Methods: 8 cases with scaphoid nonunion underwent preoperative CT scan and DICOM data were obtained, which was imported to a 3D designing software. According to the location of the nonunion, three fixing axes were designed, and then the percutaneous plate was designed around the skin surface. 3D printing was used to produce the plate with a material with medical compatibility. The plate was used during the surgery to introduce precisely k-wire percutaneous fixation, intraoperative application of arthroscopy graft technology was used at the following procedure.

Results and Conclusions: There were 8 patients, all male, with an average age of 26.9 years (20~41 years), 6 patients on the left and 2 patients on the right. All the patients got union in the last follow-ups. The VAS score and the PRWE score got improved with a satisfying functional recovery. 3D-printing assisted arthroscopic bone graft fixation of scaphoid nonunion is an effective clinical treatment with a good union rate and wrist function recovery.