Clinical effect of 3D printing guide plate combined with open reduction and bone graft hollow nail fixation in the treatment of scaphoid fractures of the wrist

Fu Dongsheng; Alimujiang·Adili

doi:10.3969/j.issn.1009-4237.2026.01.007

Abstract：Objective To observe the clinical effect of 3D printing guide plate combined with open reduc-tion and bone graft hollow nail fixation in the treatment of scaphoid fractures of the wrist.Methods A total of 66 patients with scaphoid fractures of the wrist who were admitted to our hospital from Apr.2021 to Jan.2024 were se-lected,with 37 males and 29 females aged 24-68 years,mean 43.5 years.The causes of fractures were 19 falls,32 road traffic accidents and 15 falls from heights.According to the improved Herbert classification,there were 25 cases of type A2,29 type B2 and 12 type B3.The time from injury to surgery was 2-12 d,mean 6.8 d.All the fractures were confirmed by X-ray,CT and MRI.They were divided into either control group(received open reduction and bone graft hollow nail fixation,35 cases)or study group(received an additional 3D printing guide plate besides open reduction and bone graft hollow nail fixation,31 cases)according to their surgical methods.Patients in both groups were followed up after surgery,for perioperative parameters,range of motion(ROM)and functional recovery of the-wrist,pain before and after surgery,complications,etc.Results Patients were followed up for 8-18 months,mean 12.6 months.The study group showed that the intraoperative blood loss was(4.4±1.0)mL,intraoperative fluoros-copy(6.6±1.3)times,operative time(28.1±3.3)min and fracture healing time(2.2±0.2)month,which were all much lower than those of the control group[(8.8±1.6)mL,(9.5±2.3)times,(39.3±4.7)min,(3.0±0.2)month].But the hospitalisation cost was much higher in the study group than in the control group(ten thou-sand CNY,2.9±0.2 vs.2.3±0.3,P<0.05).The wrist function score in the study group was 66.9±3.2 at post-operative 1 month and 82.2±5.1 at postoperative 6 months,much higher than the 58.3±4.2 and 73.9±6.1 in the control group;while the VAS in the study group was2.3±0.1 and1.6±0.1,respectively,much lower than the 3.1±0.1 and 2.4±0.1 in the control group(P<0.05).Moreover,at postoperative6 months,the study group a-chieved a palm-flexion ROM of 36.5°±2.6°,dorsiflexionROM of 13.5°±1.6°,radial flexion ROM of 12.3°±1.3° and ulnar flexion ROM of 23.5°±1.4°,all much higher than the 33.6°±2.9°,11.9°±1.7°,10.4°±1.2°,and19.6°±1.2° in the control group(P<0.05).Incidence of complications showed no significant difference be-tween the two groups(P>0.05).Conclusion 3D printing guide plate combined with open reduction and bone graft hollow nail fixation in the treatment of scaphoid fracture of the wrist can improve perioperative parameters,re-duce postoperative pain and improve wrist joint function.