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Minimally Invasive Percutaneous Screw Guided by 3-Dimensional–Printed Guide for the Treatment of Scaphoid Fractures

Published:November 02, 2022DOI:https://doi.org/10.1016/j.jhsa.2022.09.020

      Purpose

      This study aimed to explore the feasibility and efficacy of percutaneous fixation of minimally displaced scaphoid waist fractures using a 3-dimensional-printed guide in 10 cases.

      Methods

      Fractures were examined using preoperative computed tomography. The skin interface and bone models were reconstructed using computed tomography data. Guidewire insertion was assisted by a guide. Computed tomography was performed 4–6 weeks after surgery until healing of the fracture was confirmed. The mean follow-up period was 7 months (range, 6–9 months). The fracture healing time, grip strength, flexion-extension arc, patient-rated wrist evaluation, and Mayo wrist score were recorded.

      Results

      A total of 6 hands were in the dominant limb. The mean operation time was 41 minutes (range, 32–70 minutes). Three (30%) scaphoids healed at 6 weeks after surgery, 8 (80%) scaphoids healed at 8 weeks after surgery, and 100% scaphoids healed at 12 weeks after surgery. After correcting for hand dominance, the mean grip strength was 84% (range, 71% to 95%) of that of the contralateral side. The flexion-extension arc was 97% (range, 82% to 100%) of that of the contralateral side. The mean Mayo wrist score was 95 (range, 85–100), and pain decreased to minimal levels. All patients returned to their preinjury activities.

      Conclusions

      Three-dimensional printing is an effective and feasible technology that can help guide intraoperative processes.

      Type of study/level of evidence

      Therapeutic V.

      Key words

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