Computer-assisted design of scaphoid reconstruction: individualized percutaneous cannulated screw fixation

doi:10.3969/j.issn.2095-4344.2014.44.023

Abstract

Abstract:

BACKGROUND: Individualized percutaneous cannulated screws fixation with the help of computer-assisted design and cast immobilization are common methods for treating nondisplaced wrist scaphoid fracture. However their clinical outcomes are still unclear.
OBJECTIVE: To compare the clinical results of individualized percutaneous cannulated screws fixation with the help of computer-assisted design and cast immobilization for treatment of Herbert type Ib scaphoid fracture.
METHODS: A total of 36 patients with fresh Herbert type Ib scaphoid fracture were divided into two groups, individualized percutaneous cannulated screws fixation with the help of computer-assisted design group (screw group, 20 cases) and cast immobilization group (cast group, 16 cases). In the screw group, cannulated screws were inserted using 0.8 mm kirschner wires from scaphoid tuberosity based on the preoperative individualization fixation parameters. The direction of the wires was guided under C-arms and Herbert screws were percutaneously immobilized after fluoroscopy. In the cast group, radial deviation and palmar flexion plaster casts were immobilized for 3 months. The time of bone union, rate of bone nonunion, time return to work, wrist motion were recorded and compared in the follow-up.
RESULTS AND CONCLUSION: All cases were followed for 10-24 months. All patients in the screw fixation group and 13 out of 16 patients in the cast group achieved bone union. The average time of bone union of the two groups was 6 weeks and 14 weeks respectively (P < 0.001). The time of returning to work was 7.6 weeks and 16.8 weeks respectively, with significant differences between the two groups (P < 0.001). The range of motion of screw fixation group at the final follow-up was 96.4°-114.4°, average 104.4°, which was significantly higher than that in the cast group (66.4°-104.2°, average 94.2°; P < 0.001). Individualized percutaneous cannulated screws fixation with the help of computer-assisted design can provide mini-invasion, high accuracy and good reproducibility, has better results than cast immobilization in the treatment of Herbert typeⅠscaphoid fractures.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: surgery, microinvasive, scaphoid, fractures, computer-assisted design, internal fixators, follow-up studies

CLC Number:

R318

Lin Xu, Zeng Jun, Guo Yong, Tan Lun. Computer-assisted design of scaphoid reconstruction: individualized percutaneous cannulated screw fixation[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(44): 7178-7182.

Figures/Tables 3

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