METHODS: From October 2018 to February 2022, 10 patients with established delayed diagnoses and presentation of minimally displaced scaphoid waist fractures were treated with 3D printed guides assisted with percutaneous internal fixation without bone grafting. This technique was based on the patient\'s preoperative CT and imported into the software. Based on Boolean subtraction, the most centralized screw placement position was identified and a customized guide was produced. Intraoperative percutaneous insertion of the guide wire was assisted by the custom guide.
RESULTS: All 10 patients were successful in one attempt. The fractures healed at a mean of 7.7 weeks postoperatively (range 6-10 weeks). At a mean follow-up of 7.7 months (6-13 months), patients had excellent recovery of wrist function with minimal pain reduction. There were no major postoperative complications and the patients all returned to their previous activities before the injury.
CONCLUSIONS: Percutaneous internal fixation based on 3D printed guides is a safe and effective technique for delayed diagnosis or presentation of patients with minimally displaced fractures of the scaphoid waist. This method allows for easy insertion of screws and avoids multiple attempts.
方法:自2018年10月至2022年2月,采用3D打印导向器辅助经皮内固定而不进行植骨治疗10例延迟诊断和表现为最小移位舟骨腰部骨折的患者。该技术基于患者的术前CT并导入软件。基于布尔减法,确定了最集中的螺钉放置位置,并制作了定制指南。术中经皮插入导丝由定制引导件辅助。
结果:所有10例患者一次成功。骨折在术后平均7.7周(6-10周)愈合。平均随访7.7个月(6-13个月),患者腕关节功能恢复良好,疼痛减轻幅度最小.术后无重大并发症,患者均恢复了受伤前的活动。
结论:基于3D打印指南的经皮内固定是一种安全有效的技术,可延迟诊断或提示舟骨腰部最小移位骨折患者。该方法允许容易地插入螺钉并且避免多次尝试。