Entwicklung der navigierten Versorgung von Kahnbeinfrakturen

Percutaneous screw fixation of nondisplaced scaphoid fractures has gained popularity but remains technically demanding. Internal fixation has been advocated in young active individuals with nondisplaced scaphoid fractures to accelerate healing, allow early wrist motion, and avoid the disadvantages with prolonged immobilization. Central placement of the screw in the proximal fragment of the scaphoid is associated with decreased time to union. The newly developed universal scaphoid splint results in complete immobilization of the wrist and allows either a dorsal or palmar surgical approach. The universal scaphoid splint offers adequate reference marker stability and successful 2D/3D-navigated fluoroscopic K-wire drilling and screw placement in the scaphoid bone. Biomechanic studies, cadaver investigations, and early clinical results support the advantages of computer-assisted surgery (CAS) compared to percutaneous screw placement.