3D printing-assisted percutaneous fixation for scaphoid pathology

Distal radius fractures (DRF) are the most common orthopedic injury, with an incidence accounting for 17.5% of all fractures in adults. Malunion remains a challenging complication after DRF, including intra-articular malunion, extra-articular angulation malunion, and radial shortening malunion. A case series of DRF Malunion underwent arthroscopic assisted treatment in our hospital. Thick fibrous scar between Scapho-lunate Interosseous ligament and Distal radius is quite common in the cases with intra-articular malunion, while TFCC injuries existed in most of the cases. Patients with dorsal angulation > 10° from neutral, underwent mini-open assisted osteotomy, reduction, bone grafting, and internal fixation. Patients with thick fibrous scar between Scapho-lunate Interosseous ligament and Distal radius, underwent arthroscopic debridement. Patients with type I TFCC injuries, underwent TFCC repair. Patients with type II TFCC injuries, underwent ulnar shortening osteotomy. Evaluation included visual analogue scale (VAS), distal radius articular surface angle, modified Mayo score, Patient-Rated Wrist Evaluation (PRWE). Postoperatively, patients demonstrated marked enhancement in wrist range of motion, pain relief and function score. Arthroscopy-assisted treatment of distal radius fracture malunion facilitated precise assessment of intra-articular pathology, guided deformity correction, and enabled concurrent management of associated soft tissue injuries. 

Keywords: Arthroscopy; Distal radius fracture; Malunion