NAVICULA SURGICAL TECHNIQUE - Adlerortho
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ANTEA
NAVICULA
PROTESI
HEMI DI CAPITELLO
SCAPHOID RADIALE
PROSTHESIS
SURGICAL TECHNIQUE
1
NAVICULA
HEMI SCAPHOID PROSTHESIS
Ceramic TiNbN Coating improves implant The implant features a through
surface hardness and biocompatibility. hole to allow for ligament fixation.
Anatomically
shaped for an
optimal fit.
• Made of Titanium with TiNbN antiallergic coating.
• Anatomically shaped.
• 4 progressively growing sizes left and right.
• Through hole for stabilisation.
3
PRESENTATION AND CHARACTERISTICS
The Navicula hemi scaphoid implant is 3D printed
from Titanium, with a TiN nitrate surface coating.
The system allows the reconstruction of the proximal
scaphoid bone. It is indicated for use with irreparable
grafts or other bone reconstructive techniques,
together with Scapho-lunate ligament reconstruction
and distal scaphoid stabilisation.
The Navicula hemi scaphoid implant is available in 4
progressively growing sizes.
The removed scaphoid fragment can be compared
with the trial implant to assist in matching the correct
size to reconstruct patient anatomy.
Further sizes are available on demand.
INDICATIONS
• Irreparable fracture outcomes, not suitable for
any graft repair.
• Failed previous reconstructive surgery.
• No SNAC ≥ 2, radio-carpal and midcarpal joint
preserved, no carpal collapse.
CONTRAINDICATIONS
• Carpal collapse.
• SNAC > 2, radio-carpal and/or mid-carpal joint
changes or destruction.
Sz. 1 Sz. 2 Sz. 3 Sz. 4
4
SURGICAL STEPS
1 • Dorsal sinusoidal incision, radial nerve branches isolated, capsulotomy along the
scaphoid axis, the proximal scaphoid fragment is removed.
2 • The correct implant size is selected, eventually comparing the trial implants with the
removed proximal scaphoid.
TIP: The fracture surface of the distal scaphoid fragment
should be flattened and trimmed to obtain the best match
with the selected implant.
5
3 • A neo-ligament, harvested from the palmar gracilis, is fixed to the lunate bone with an
appropiate bone anchor (not included in the Navicula Kit) and then passed into the
hole made in the Navicular hemi scaphoid.
4 • A 2.7 mm hole is drilled in the distal fragment of the scaphoid and the neo-ligament is
passed through it and tensioned.
TIP: steps 3 and 4 are greatly eased by using an appropriate Tendon passer.
6
5 • The ligament is fixed into the distal fragment hole with an interference screw.
NOTE: The interference screw is not included in the Navicula
hemi scaphoid surgical kit.
6 • The remaining ligament part is reflected and secured to the radio-carpal peripheral
ligament with a buttonhole suture, adding to the procedure a scaphoid head stabilisation.
7
Post-op x-ray must indicate that the scapho-lunate space is closed and Gilula arcs
have been correctly restored.
7 • The dorsal capsule is then sutured with non-
absorbable stitches.
TIP: capsular suture to be performed in a
semi-flexed wrist position.
In case of damaged capsule, use a flap of
extensor retinaculum to complete or reinforce
the capsular reconstruction.
8 • Post-op treatment will include 4 weeks of
wrist immobilisation with a light thermoplastic
splint, followed by 2 months rehabilitation.
8
BIBLIOGRAPHY
A.B. Swanson et al. "Scaphoid implant resection arthroplasty. Long-term results". The Journal of
Arthroplasty; 1(1):47-62. 1986.
A.B. Sattel, A.B. Swanson, G. De Groot Swanson: "Titanium scaphoid implant for scaphoid
nonunion". Operative Techniques in Orthopaedics. Volume 2, Issue 1, pagg. 32-38, 1992.
M.I. Rossello et.al.: "La sostituzione protesica dello scafoide carpale". Riv. Chir: Riab.Arto Sup.
XXXI, 1, 1994.
M.I. Rossello, M. Costa, M. Bertolotti: "La susticion protesica del escafoides carpiano". Rev Esp.
Cir. mano N° 48,Vol. 21, 1994.
M.I. Rossello, F. Moretti, G. Priano, G. Novara: "Scaphoid total arthroplasty: our 20 years
experience in 71 cases". Abstract book 6th Congress IFSSH, rif. P 083, 1995.
M. I Rossello, M. Bertolotti, M. Costa, V. Pizzorno: "Prosthetic reconstruction of proximal pole of
scaphoid bone: a new approach". Abstract book 6th Congress IFSSH, rif. 040, 1995.
M.I. Rossello, H. Maurer, M. Bertolotti, E. Orunesu, C. Becce: "Un nuovo modello di protesi
parziale di scafoide". Riv. chir. riab. mano Arto sup. 32 (1), 1995. Presentation at the 6th IFFSH
Congress, Helsinki 1995.
M.I. Rossello, M. Bertolotti, P. Bertolotti, R. Mantero: "La sostituzione protesica parziale dello
scafoide: un'idea nuova per un problema antico (protesi Eminaos)”. Riv, Chir. Riab. Mano Arto
Sup. 33 (2), 1996.
M.I. Rossello, M. Costa, V. Pizzorno: "La sostituzione protesica" Cap. 12 de "Lo scafoide".
Monografia della SICM, Casa Ed. Mattioli, Parma 1997.
M.I. Rossello: "Trattamento degli insuccessi nella patologia dello scafoide: le protesi”. Riv Chir
Riab Mano 38 (2), 2001.
O. Spingardi, M.I. Rossello: "The total scaphoid titanium arthroplasty: a 15 year experience".
HAND 6;179-184, 2011.
M.I. Rossello, A. Zoccolan, O. Spingardi: "Protesi totale di scafoide in titanio". Medicina e chirurgia
ortopedica ricerca tecnologia innovazione, Vol. 1, 2012.
M.I. Rossello, O. Spingardi: "The total scaphoid titanium arthroplasty". Arch,.Ortop. Reum. Vol.
126, 1-3 2015.
M.I. Rossello. "A case of total scaphoid titanium custom-made 3D-printed prostheses with one-
year follow-up". Case Reports in Plastic Surgery and Hand Surgery. VOL. 7, NO. 1, 7–12. 2020.
9
IMPLANTS
Code Description
3400101 NAVICULA HEMI SCAPHOID SIZE 1 LEFT
3400102 NAVICULA HEMI SCAPHOID SIZE 2 LEFT
3400103 NAVICULA HEMI SCAPHOID SIZE 3 LEFT
3400104 NAVICULA HEMI SCAPHOID SIZE 4 LEFT
3400111 NAVICULA HEMI SCAPHOID SIZE 1 RIGHT
3400112 NAVICULA HEMI SCAPHOID SIZE 2 RIGHT
3400113 NAVICULA HEMI SCAPHOID SIZE 3 RIGHT
3400114 NAVICULA HEMI SCAPHOID SIZE 4 RIGHT
SIZE A B C A A
1 14.4 9.1 8.7
2 15.4 9.5 9.2 B B
3 16.2 9.8 9.7
4 17.1 10.3 10.2
C C
10Manufactured by ADLER ORTHO SpA ADLER ORTHO UK
Manufacturing Unit The Stables
and main office Tarvin Road
Via dell’Innovazione 9 Frodsham - Cheshire -
20032 Cormano (Mi) WA6 6XN
Tel. +39 02 6154371 Tel: +44151 329 3372
02 - 2021
Fax +39 02 615437222
www.adlerortho.com
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