Replacement of a destroyed scaphoid by a 3D modelled prosthesis

Abstract

Preiser disease is a rare condition where ischaemia and necrosis of the scaphoid bone occurs without previous fracture. A female patient in her 30s presented with severe right wrist pain caused by Preiser disease. Initially, she was treated by a pedicled vascularised bone graft, but unsuccessfully. Four years after the initial diagnosis, the affected scaphoid was replaced by a 3D modelled prosthesis. Three years after the operation, the patient had significant pain reduction, good wrist function and grip strength. Final X-rays demonstrated no signs of dislocation of the implant or signs of periprosthetic arthritis. Studies have shown that once scaphoid non-union advanced collapse occurs, treatment should consist of either a proximal row carpectomy or scaphoidectomy and four corner fusion. In our case, despite collapse and previous surgery, replacement of the single affected bone by a 3D modelled prosthesis lead to good return of function.