复杂髋臼骨折复位及内固定的数字技术模拟研究

中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (4): 393-396.

复杂髋臼骨折复位及内固定的数字技术模拟研究

宋军¹，　梅益彰²，　吴增城²，　李明君²，　阮玉婷²，　李鉴轶³，　林荔军⁴

1.南方医科大学体育部，广州 510515；　2.南方医科大学第二临床医学院，广州 510282；　3.南方医科大学解剖学教研室
广东省医学生物力学重点实验室，广州 510515； 4.南方医科大学珠江医院骨科，广州 510282

收稿日期:2013-03-20 出版日期:2013-07-25 发布日期:2013-07-24
通讯作者: 荔军,副主任医师， Tel:(020)61643262, E-mail: linlijun 1@126.com E-mail:penghg@fimmu.com
作者简介:宋军(1968- )，女，副教授，主要从事运动损伤预防研究， Tel:(020)61648192
基金资助:
广东省自然科学基金（S2011040003604，S2011010004179）广东省省部产学研基金（2010B090400425，2009B090300279）；广州市科技计划项目（2011J4300108-1）

The digital simulation of fracture reduction and fixation of complicated acetabular fractures

SONG Jun¹, MEI Yi-zhang²，WU Zeng-cheng²，LI Ming-jun², RUAN Yu-ting², LI Jian-yi³, LIN Li-jun⁴

1.Department of Sports, Southern Medical University，Guangzhou 510515，China; 2.The Second Clinical College, Southern Medical University，Guangzhou 510282, China; 3.Department of Anatomy, Guangzhou 510515，China; 4.Department of Orthopaedics, Zhujiang Hospital, Southern Medical University，Guangzhou 510282, China

Received:2013-03-20 Online:2013-07-25 Published:2013-07-24

摘要/Abstract

摘要：

目的　探讨数字医学技术在复杂髋臼骨折复位及手术模拟中的应用。方法　采集1例髋臼骨折患者的骨盆CT图像，在Mimics 14.01软件上进行三维重建，并利用Geomagic Studio 11.0软件进行骨折的复位和内固定的手术模拟，提出手术指导方案。术后三月再次采集患者骨盆CT图像，三维重建后与术前设计进行比较，评价应用数字技术开展复杂髋臼骨折的术前设计的效果。结果　根据Tile分型：该病例为C2-3型。Mimics软件重建的骨盆三维模型可准确反映复杂性髋臼骨折的三维立体结构，利用Geomagic软件移动骨折碎片，进行骨折复位，并精确测量出相关的各项数据和进行内固定的放置设计。术后随访钢板与螺钉非常接近术前设计的位置。结论　应用数字医学技术有助于直观地显示骨盆内部情况并明确分型，并能实现骨折复位及内固定模拟等操作，实现复杂髋臼骨折的术前设计，提高了手术精确性。

关键词: 复杂髋臼骨折, 术前设计, 手术模拟, 数字医学技术

Abstract:

Objective　To investigate the fracture reduction and implant simulation of complicated acetabular fractures using digital medical technologies. 　Methods　CT image of one case of complicated acetabular fractures was obtained and imported into software Mimics. Geometry models of pelvis were three-dimensionally (3D) reconstructed. Fracture Reduction and implant simulation were performed in software Geomagic, which served as a surgical guidance. The CT images of the same patient were obtained again 3 months after the operation. The postoperative models were also reconstructed for comparison and evaluation. Results　According to the Tile classification, the case was type C2-3. By using Mimics software, the 3D model accurately reflected the structure of pelvis with complicated acetabular fractures. With bone fragments being moved and rotated in Geomagic, fracture reduction and implant simulation were performed. The post-operation effect was good after following-up. The positions of plates and screws in pre- and post-operation stages were very close.　Conclusions　The digital medical technologies are very useful for fracture reduction and implant simulation, which can improve the accuracy of the surgery.

Key words: Complicated acetabular fractures, Preoperative planning, Surgery simulation, Digital medical technology

中图分类号:

R323.45

宋军, 梅益彰, 吴增城, 李明君, 阮玉婷, 李鉴轶, 林荔军. 复杂髋臼骨折复位及内固定的数字技术模拟研究[J]. 中国临床解剖学杂志, 2013, 31(4): 393-396.

SONG Jun, MEI Yi-Zhang, TUN Ceng-Cheng, LI Meng-Jun, RUAN Yu-Ting, LI Jian-Die, LIN Li-Jun. The digital simulation of fracture reduction and fixation of complicated acetabular fractures[J]. Chinese Journal Of Clinical Anatomy, 2013, 31(4): 393-396.

参考文献

[1] 吴宏华，王满宜，吴新宝，等. 常规髋臼手术入路加大转子截骨治疗复杂髋臼骨折
[J]. 中华创伤骨科杂志,2012,14(5):372-375.

[2] 武成兴，吴军，王小强，等. 复杂髋臼骨折的手术治疗及疗效分析
[J]. 重庆医学,2012,41(31):3324-3325.

[3] 连鸿凯，李兴华，王爱国，等. 经髂腹股沟和Kocher—Langenbeck联合入路治疗复杂移位髋臼骨折
[J]. 中华骨科杂志, 2011, 31(11):1250-1254.

[4] 黄美贤，罗吉伟，胡罢生，等. 三维螺旋CT重建股骨远端旋转力线的测量
[J]. 中国临床解剖学杂志,2008,26(1):62-64.

[5] Lu S, Xu Y Q, Chen G P, et al. Efficacy and accuracy of a novel rapid prototyping drill template for cervical pedicle screw placement
[J]. Comput Aided Surg, 2011, 16(5):240-248.

[6] Fu M, Lin L, Kong X, et al. Construction and accuracy assessment of patient-specific biocompatible drill template for cervical anterior transpedicular screw (ATPS) insertion: An in vitro study
[J]. PLoS One,2013,8(1):e53580.

[7] 唐雷. 数字医学技术与精准外科手术
[J]. 中国实用妇科与产科杂志, 2012, 28(1):7-9.

[8] 顾冬云. 数字医学与骨科临床诊疗技术的新发展
[J]. 中华创伤骨科杂志,2008,10(2):111-112.

[9] 许猛，张立海，张里程，等. 复杂髋臼骨折术中应用CT扫描的意义
[J]. 中华骨科杂志,2011,31(11):1261-1265.

[10] 吕厚忠，黄海样，张建春，等. 数字骨科技术在髋臼骨折手术中的应用
[J]. 中国骨科临床与基础研究杂志,2011, 3(3):193-198.

[11]Gary J L, Lefaivre K A, Gerold F, et al. Survivorship of the native hip joint after percutaneous repair of acetabular fractures in the elderly
[J]. Injury, 2011, 42(10):1144-1151.

[12]Briffa N, Pearce R, Hill A M, et al. Outcomes of acetabular fracture fixation with ten years' follow-up
[J]. J Bone Joint Surg Br,2011,93(2):229-236.