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Scaphoid non-union with pre-existing screws treated by 3D preoperative planning
  1. Satoshi Oki,
  2. Tomoki Matsuo,
  3. Ryogo Furuhata and
  4. Shohei Iwabu
  1. Department of Orthopedic Surgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan
  1. Correspondence to Dr Satoshi Oki; satoshiohki{at}gmail.com

Abstract

Scaphoid fractures, if deemed operative, can often be treated successfully by headless compression screw fixation. Unfortunately, some patients go on to develop a scaphoid fracture non-union with screw loosening, bone resorption, bone deformity and carpal malalignment. To assist surgeons in managing these difficult cases, specifically designed scaphoid fracture plates have recently been introduced. We present a case of a scaphoid fracture non-union with retained screws and bone loss that was effectively treated by volar plate fixation using a three-dimensional (3D) printed model to assist with restoration of scaphoid morphology and implant positioning. Before surgery, 3D preoperative planning using a surface registration technique and a 3D printer was performed. Referring to the 3D-printed reduced model facilitated the prediction of gaps after reduction and helped decide the implant position and screw directions. Carpal alignment parameters gradually improved by 1 year postoperatively.

  • orthopaedic and trauma surgery
  • radiology

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Footnotes

  • Contributors SO performed preoperative simulation and surgery and analysed the data. TM and RF supported the surgery and rehabilitation. SI managed strategy for the treatment and instructed the surgery.

  • Funding This study was funded by AO Trauma Asia Pacific (AOTAP grant 2019).

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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