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3D-Printed Patient-Specific Guides Versus Conventional Techniques for Scaphoid Reconstruction: A Comparative Study of
Sylvano Mania1, Mauro Maniglio1, Michael A Wirth1
1Orthopaedic Department, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Summary
Patient-specific instrumentation (PSI) offers improved correction for complex scaphoid deformities compared to conventional methods. While both techniques achieve bone healing, PSI demonstrates superior accuracy in restoring wrist biomechanics.
Area of Science:
- Orthopedic surgery
- Biomechanical engineering
- Radiology
Background:
- Scaphoid non-union/malunion causes 3D deformity, altering wrist biomechanics.
- Patient-specific instrumentation (PSI) aims to enhance reconstruction accuracy.
- Quantitative comparisons between PSI and conventional free-hand techniques are limited.
Purpose of the Study:
- To quantitatively compare the accuracy of patient-specific instrumentation (PSI) versus conventional free-hand techniques in correcting three-dimensional (3D) scaphoid deformities.
- To assess the impact of PSI on wrist biomechanics and scaphoid alignment.
Main Methods:
- Retrospective analysis of 115 scaphoid reconstructions (89 included: 45 PSI, 44 conventional).
- Quantification of distal-fragment rotation and translation using a Cartesian coordinate system.
- Calculation of a composite 3D deformity angle to assess global malalignment.
Main Results:
- PSI achieved greater absolute correction in sagittal flexion (8.9° vs 5.8°) and ulnar inclination (3°).
- The composite 3D deformity angle decreased more with PSI (8.4°) than conventional (6.9°).
- Consolidation rates and times to union were comparable between PSI and conventional techniques, despite longer non-union duration in the PSI group.
Conclusions:
- Both PSI and conventional techniques effectively correct scaphoid deformity.
- PSI enables more significant morphological corrections, particularly in complex or long-standing deformities.
- Further research is needed to determine the clinical relevance of 3D differences and operative efficiency.
