Computed tomography-based three-dimensional preoperative planning for total wrist arthroplasty

Total wrist arthroplasty is indicated for severely damaged joints; however, it is sometimes difficult to place the implant in the proper position. We report a case of total wrist arthroplasty using computed tomography (CT)-based 3D planning. After a 3D digital model of the wrist was reconstructed using preoperative planning software, the computer-aided design models of the implant were superimposed on the wrist and the appropriate size and position of the implant were determined. During surgery, the planned parameters were measured using a slide gauge to reproduce the planned position of the implant. The size of the implant used at surgery was the same as in 3D planning. Comparing the CT before and after surgery, the position of the implant was almost the same as in 3D planning on the radial side, but the carpal side was placed 7 mm proximal to the position in preoperative planning. Two years after surgery, the patient had no complications and radiography showed no obvious signs of aseptic loosening. Our method may contribute to a reduced incidence of complications, such as intraoperative fracture and postoperative dislocation, leading to improve long-term outcomes of total wrist arthroplasty.