目的 探讨术前计算机辅助设计结合三维打印技术,制备个体化舟骨螺钉导向模板的可行性,并评估其辅助置钉的精确度.方法 选取8例成人腕关节的标本,将其CT扫描数据导入VxWork软件,对舟骨进行三维重建,选取合适钉道,建立与腕关节周围皮肤相贴合的模具,并利用三维打印技术将其打印为导向模板.将此打印模板安置于尸体标本腕关节周围,经打印出的预置孔道打入螺钉导针.术后行CT扫描,对比术前术后的CT图像,对比导针的位置及打入深度的精确程度.结果 螺钉导针位置精确度:6例偏差<1 mm,2例偏差<2 mm.导针打入深度:6例偏差<1 mm,2例偏差<2 mm.所有操作均为一次成功,且导针均在舟骨内,导针位置符合临床要求.结论 本研究结果表明,基于CT图像,使用软件能够精确建立舟骨螺钉打入通道,三维打印出的个体化导航模板,辅助置钉准确性高、操作简单,为舟骨骨折螺钉的精确置入提供了一种可供选择的新方法.“,”Objective To investigate the feasibility of establishing an individualized guide template for scaphoid screw insertion using computer-assisted design and three dimensional ( 3D ) printing technique, and to evaluate the accuracy and safety of this technique. Methods Eight adult wrist specimens were scanned by computed tomography ( CT ) scanner. All CT volume data of 8 wrists were imported into the VxWork software and surface scaphoid models were reconstructed. We selected a proper tunnel of optimal screw guide wire position and then created a template matching to the wrist. A screw guiding template was created by 3D printing technique. Postoperative CT scans were obtained to evaluate the accuracy of screw position and insertion depth. Results A grading scheme was used to assess the drilling accuracy: Grade 1 < 1 mm deviation, Grade 2 < 2 mm deviation. Scaphoid drilling was conformed to be completely accurate ( Grade 1 ) in 6 specimens, highly accurate ( Grade 2 ) in 2 specimens. No specimen required a repeated drilling of the scaphoid. All the screws were in the scaphoid, whose positions met the clinical requirements. Conclusions This study has shown that a proper tunnel for scaphoid screw insertion can be created bases on CT scanning. Scahpoid screw insertion guided by a 3D printing template has been proved to be accurate and easy to operate and this technique could be a new alternative to conventional technique.