Three-Dimensional Printed Targeting Device for Scaphoid Fracture Fixation.

Area of Science:

• Orthopedic Surgery
• Medical Device Technology
• Radiology

Background:

• Percutaneous scaphoid screw fixation is challenging, often requiring multiple attempts and leading to significant radiation exposure.
• A 3-dimensional (3D) printed targeting device offers a potential solution to improve efficiency and reduce radiation.
• Scaphoid fractures are common wrist injuries requiring precise surgical intervention.

Purpose of the Study:

• To evaluate the efficacy of a 3D printed targeting device for percutaneous scaphoid guide wire insertion.
• To compare procedure time, radiation exposure, and accuracy between the targeting device and freehand techniques.
• To assess the impact of the device on surgical workflow and patient safety.

Main Methods:

• A custom 3D printed targeting guide was created using preprocedure CT scans of cadaver wrists.
• Orthopedic surgery residents performed guide wire insertions using both freehand and targeting device techniques on cadaver specimens.
• Procedure times, fluoroscopy exposure, and K-wire accuracy (central third placement) were measured and compared.

Main Results:

• The targeting device group had an average procedure time of 30 seconds with no fluoroscopy exposure, versus 21 minutes and significant radiation for the freehand group.
• Both techniques achieved similar accuracy, with K-wires placed in the central scaphoid in four instances each.
• The targeting device demonstrated an average linear deviation of 2.1 mm from the planned trajectory.

Conclusions:

• The 3D printed targeting device significantly reduces procedure time and intraoperative radiation exposure for scaphoid guide wire insertion.
• The device achieves comparable accuracy to the freehand technique.
• This technology holds promise for improving the safety and efficiency of scaphoid fracture fixation.