Titanium patient-specific scaphoid replacement for unreconstructable nonunions: a case series study

Area of Science:

• Orthopedic surgery
• Biomaterials engineering
• Medical device technology

Background:

• Scaphoid nonunions often require reconstruction, but this is not always feasible due to poor bone quality or arthritis.
• Current salvage procedures for unreconstructable scaphoid nonunions can negatively impact wrist function.

Purpose of the Study:

• To evaluate the efficacy of a patient-specific, 3-D-printed titanium scaphoid implant as an alternative treatment for unreconstructable scaphoid nonunions.
• To assess functional and radiographic outcomes following implantation of custom 3-D-printed scaphoid prostheses.

Main Methods:

• A retrospective case series involving 12 patients with unreconstructable scaphoid nonunions treated with 3-D-printed titanium implants.
• Assessment of patient-reported outcomes, range of motion, grip strength, and plain radiographs before and after surgery.
• Mean follow-up duration of 2 years and 8 months.

Main Results:

• Postoperative improvements were observed in range of motion and patient-reported outcome scores, though motion improvement was not statistically significant.
• Radiographic evaluation showed satisfactory alignment in all but one implant, with no progression of degenerative changes.
• The 3-D-printed scaphoid implants demonstrated good integration and stability.

Conclusions:

• Patient-specific 3-D-printed titanium scaphoid replacement presents a promising alternative to traditional salvage procedures for complex scaphoid nonunions.
• This technique may offer a functional solution for patients with unreconstructable scaphoid fractures, preserving wrist function.
• Further research with larger cohorts is warranted to confirm long-term efficacy and outcomes.