三维可视化技术在Chevron手术治疗母外翻术前规划中的应用探讨

吕志宇, 赵义荣, 俞春生, 李继川, 邵志民

中国临床解剖学杂志 ›› 2017, Vol. 35 ›› Issue (1) : 94-97.

中国临床解剖学杂志 ›› 2017, Vol. 35 ›› Issue (1) : 94-97. DOI: 10.13418/j.issn.1001-165x.2017.01.019
临床研究

三维可视化技术在Chevron手术治疗母外翻术前规划中的应用探讨

  • 吕志宇, 赵义荣, 俞春生, 李继川, 邵志民
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The application of three-dimensional visualization technique in preoperative planning of Chevron Osteotomy for treatment of hallux valgus

  • LV Zhi-yu1,ZHAO Yi-rong1,YU Chun-sheng1,LI Ji-chuan1,SHAO Zhi-ming2
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摘要

目的 探讨三维可视化技术在Chevron手术治疗母外翻术前规划中的应用价值。  方法 2014年1月至2015年12月本科室收治的20例轻度、中度母外翻患者,年龄48~72岁,行三维螺旋CT下0.625 mm薄层扫描,在M3D软件中三维图像处理系统上进行建模、模拟截骨,测量母 外翻角、第1,2跖骨间角,在不同截骨角度值下比较各测量值间的差异。  结果    数字化重建母 外翻模型、模拟截骨后按术前规划进行手术,与矫形后影像学表现进行比对,两者相符程度很高。AOFAS评分明显升高,患者满意度较高。 结论    三维重建母 外翻患者足部负重位模型可以清楚显示第1跖列在三维空间上的位置改变,为Chevron 截骨面设计,矫形后第1跖骨头的三维数据测量等提供量化依据。个性化制订母 外翻矫形手术方案,使足部形态及负重功能更好,术后患者满意度提高。

Abstract

Objective To Discuss the benefit of the three-dimensional visualization technique in preoperative planning of Chevron Osteotomy for treatment of hallux valgus. Methods  From January 2014 to December 2015, the 3D visualization preoperative planning technique was applied to 20 admitted patients aged 48-72 years old with mild to moderate hallux valgus.  The image processing software M3d was performed to analyze the images obtained from 3D spiral CT with 0.625 mm thin slices, generate the hallux valgus model, simulate the osteotomy, measure hallux valgus angle (HVA) and 1st-2nd intermetatarsal angle (IMA), and compare measurements at different osteotomy angles. Results With the guidance of the preoperative planning made through digital reconstruction model of hallux valgus and osteotomy simulation, the imaging findings after osteotomy correction highly agreed with the one made from 3D virtual surgery.  AOFAS scores were significantly increased, as well as patient satisfaction. Conclusions The 3D foot weight-bearing reconstruction model for hallux valgus patient clearly shows the position change of the first metatarsal column in a 3D space.  It also provides a quantitative basis for Chevron osteotomy surface design and 3D post-treatment measurement of the first metatarsal head. Hallux valgus correction treatment should be designed to accommodate individual differences, so that the foot shape looks better and weight-bearing function works better to improve patient satisfaction after Chevron osteotomy.

关键词

  / Chevron 截骨术 / 母 外翻 / 三维重建

Key words

The Chevron osteotomy for hallux valgus / Hallux  / valgu / Three-dimensional reconstruction

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导出引用
吕志宇, 赵义荣, 俞春生, 李继川, 邵志民. 三维可视化技术在Chevron手术治疗母外翻术前规划中的应用探讨[J]. 中国临床解剖学杂志. 2017, 35(1): 94-97 https://doi.org/10.13418/j.issn.1001-165x.2017.01.019
LV Zhi-yu1,ZHAO Yi-rong1,YU Chun-sheng1,LI Ji-chuan1,SHAO Zhi-ming2. The application of three-dimensional visualization technique in preoperative planning of Chevron Osteotomy for treatment of hallux valgus[J]. Chinese Journal of Clinical Anatomy. 2017, 35(1): 94-97 https://doi.org/10.13418/j.issn.1001-165x.2017.01.019

参考文献

[1]  Chen L,Lyman S,Do H,et al.Validation of foot and ankle outcome score for hallux valgus[J].Foot Ankle Int,2012, 3(12):1145-1155.
[2]  Roddy E, Zhang W, Doherty M. Prevalence and associations of hallux valgus in a primary care population[J].  Arthritis Rheum,2008, 9(6):857-862.
[3] Coughlin MJ, Jones CP. Hallux valgus: demographics, etiology, and radiographic assessment[J]. Foot Ankle Int,2007, 8(7):759-777.
[4]  史思峰,董杨. 母外翻主要病理改变及组织修复方法的选择[J].中国组织工程研究与临床康复,2009,3(50):9958-9961.
[5]  Dobson MH, Nguyen C. Modern concepts in the treatment of hallux valgus[J]. Bone Joint Surg Br, 2006,88(2):276-279.
[6] Deenik AR, Pilot P,Brandt SE, et al .Scarf versus chevron osteotomy in hallux valgus: A randomized controlled trial in 96 patients[J].Foot Ankle Int,2007,28(5):537-541.
[7] Deenik A, van Mameren H, de Visser E,et al. Equivalent correction in scarf and chevron osteotomy in moderate and severe hallux valgus: a randomized controlled trial[J]. Foot Ankle Int, 2008,29(12):1209-1215.
[8]  钟世镇,原林,黄文华. 数字化虚拟人体为临床解剖学开拓研究新领域[J]. 中国临床解剖学杂志, 2002, 20(1): 3-4.
[9]   张元智,李严兵,唐茂林,等. 数字化与虚拟现实技术在皮瓣移植中的作用[J]. 中华创伤骨科杂志, 2006, 8(6):501-504.


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