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Cioffi A, Rovere G, Bosco F, Sinno E, Stramazzo L, Liuzza F, Ziranu A, Romeo M, Vigni GE, Galvano N, Maccauro G, Farsetti P, Rossello MI, Camarda L. Treatment of Scaphoid Non-Unions with Custom-Made 3D-Printed Titanium Partial and Total Scaphoid Prostheses and Scaphoid Interosseous Ligament Reconstruction. Healthcare (Basel) 2023; 11:3123. [PMID: 38132013 PMCID: PMC10743063 DOI: 10.3390/healthcare11243123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 12/02/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Treatment of scaphoid fracture sequelae is still an unsolved problem in hand surgery. Custom-made 3D-printed titanium partial and total scaphoid prosthesis and scaphoid interosseous ligament reconstruction (SLIL) are performed in cases of non-union and isolated aseptic necrosis of the proximal scaphoid pole and when it is impossible to save the scaphoid bone, respectively. This study aims to evaluate the clinical, functional and radiographic results after these two prosthesis implantations. METHODS Between January 2019 and July 2020, nine partial and ten total scaphoid prostheses were implanted using custom-made 3D-printed titanium implants. Evaluation criteria included carpal height ratio (CHR), radioscaphoid angle, wrist extension and flexion, radial deviation and ulnar deviation of the wrist, grip strength and pinch strength, Visual Analogue Scale (VAS), the Disabilities of Arm, Shoulder, and Hand (DASH) score, and the Patient-Rated Wrist Evaluation (PRWE). RESULTS Clinical, functional, and radiographic improvements were found in all outcomes analyzed for both patient groups. The VAS pain scale obtained the most remarkable improvement at the one-year follow-up. The results of the DASH scores and the PRWE were good, with a great rate of patient satisfaction at the end of the follow-up. SLIL reconstruction also provided excellent stability and prevented a mid-carpal bone collapse in the short- and medium-term follow-up. CONCLUSIONS A custom-made 3D-printed titanium partial or total scaphoid prosthesis is a viable solution for patients with scaphoid non-union and necrosis or complete scaphoid destruction in whom previous conservative or surgical treatment has failed.
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Affiliation(s)
- Alessio Cioffi
- Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, 90133 Palermo, Italy; (A.C.); (L.S.); (M.R.); (G.E.V.); (N.G.)
| | - Giuseppe Rovere
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.R.); (F.L.); (A.Z.); (G.M.)
- Department of Clinical Science and Translational Medicine, Section of Orthopaedics and Traumatology, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Francesco Bosco
- Department of Orthopaedics and Traumatology, University of Turin, 10126 Turin, Italy;
| | - Ennio Sinno
- Orthopaedic and Traumatology Department, S. Spirito Hospital, 00193 Rome, Italy;
| | - Leonardo Stramazzo
- Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, 90133 Palermo, Italy; (A.C.); (L.S.); (M.R.); (G.E.V.); (N.G.)
| | - Francesco Liuzza
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.R.); (F.L.); (A.Z.); (G.M.)
| | - Antonio Ziranu
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.R.); (F.L.); (A.Z.); (G.M.)
| | - Michele Romeo
- Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, 90133 Palermo, Italy; (A.C.); (L.S.); (M.R.); (G.E.V.); (N.G.)
| | - Giulio Edoardo Vigni
- Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, 90133 Palermo, Italy; (A.C.); (L.S.); (M.R.); (G.E.V.); (N.G.)
| | - Nicolò Galvano
- Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, 90133 Palermo, Italy; (A.C.); (L.S.); (M.R.); (G.E.V.); (N.G.)
| | - Giulio Maccauro
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.R.); (F.L.); (A.Z.); (G.M.)
| | - Pasquale Farsetti
- Department of Clinical Science and Translational Medicine, Section of Orthopaedics and Traumatology, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Mario Igor Rossello
- Hand Surgery Department “Renzo Mantero”, Ospedale San Paolo, 17100 Savona, Italy;
| | - Lawrence Camarda
- Department of Orthopaedic Surgery (DICHIRONS), University of Palermo, 90133 Palermo, Italy; (A.C.); (L.S.); (M.R.); (G.E.V.); (N.G.)
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