A review of digital orthopedic techniques in pre- and intra-operative management of scaphoid fracture

Abstract Digital orthopedics integrates artificial intelligence, finite element analysis, virtual surgical planning, intraoperative navigation, robotics, and three-dimensional printing into a precise, individualized workflow for scaphoid fracture management. Artificial intelligence-based algorithms achieve high diagnostic accuracy for scaphoid fractures on plain radiographs, aid in detecting occult fractures, and support treatment decisions. Three-dimensional fracture mapping and finite element analysis enable quantitative assessment of fracture morphology and biomechanical stability, supporting individualized preoperative planning. Computer-assisted navigation reduces radiation exposure and guidewire attempts compared with conventional fluoroscopy but remains limited by registration inaccuracy and dependence on manual execution. Robot-assisted surgery improves procedural consistency and screw accuracy, with a learning curve of approximately 10–20 cases; however, it is constrained by longer setup times, high costs, and predominantly level IV evidence. Virtual surgical planning combined with three-dimensional printing provides patient-specific percutaneous guides, reduction templates, anatomical models, and custom prostheses, improving accuracy, reducing radiation exposure, and enabling motion-preserving salvage for scaphoid nonunions and scaphoid nonunion advanced collapse. Current evidence is largely based on small case series and cadaveric studies, highlighting the need for standardized protocols and high-quality comparative trials to support widespread adoption.