The clinical application of individualized three-dimensional printing guiding template for assisting scaphoid fracture fixation through dorsal approach.

ABSTRACT

The purpose is to introduce a novel scaphoid screw placement surgery based on a novel three-dimensional (3D) printing guiding template through dorsal approach, and to evaluate the clinical feasibility and accuracy. The diagnose of scaphoid fracture was confirmed by Computed Tomography (CT) scanning, and subsequently the CT scanning data was input into a three-dimension imaging system(Hongsong software, China). An individualized 3D skin surface template with a guiding hole was printed. We put the template to the correct position on patient's wrist. Fluoroscopy was used to confirm the accurate position after drilling of Kirschner wire according to the prefabricated holes of template. Finally, the hollow screw was inserted through the wire. The operations were performed successfully without incision and complications. The operation time was below 20 minutes and the blood loss was below 1ml. The intraoperative fluoroscopy demonstrated good position of the screws. Postoperative imaging showed that the screws were considered to be placed perpendicularly to the fracture plane in the scaphoid. Three months after the operation, the patients acquired good recovery of the motor function of their hands. This present study suggested that the computer-assisted 3D printing guiding template is effective, reliable, and minimally invasive for the treatment of type B scaphoid fracture through dorsal approach.