应用解剖

数字优化设计在喙锁韧带重建术中骨隧道精准定位的应用

展开
  • 1.西南医科大学附属中医医院骨伤科,  四川    泸州    646000;    2.西南医科大学附属中医医院骨伤疾病研究中心,  四川   泸州    646000;    3.西南医科大学体育学院,  四川   泸州    646000;    4.宜宾市中西医结合医院康复科,  四川  宜宾    644100;    5.西南医科大学中西医结合学院,  四川   泸州   646000
张磊(1987-),男,四川宜宾人,医学博士后,主要研究方向:肩肘及足踝疾病基础及临床研究,E-mail:307501597@qq.com

收稿日期: 2022-12-13

  网络出版日期: 2023-08-02

基金资助

国家自然科学基金课题(青年科学基金项目,82004458);四川省中医药管理局中医药科研课题(2020JC0138);四川省医学会骨科(尚安通)专项科研课题(2020SAT26);四川省科技厅中央引导地方科技发展资金面上项目(2021ZYD0078);西南医科大学附属中医医院科研团队培育项目(2022-CXTD-08);泸州市科技计划项目(2022-JYJ-163)

Application of digital optimization design in coracoclavicular ligament reconstruction for precise positioning of the bone tunnel

Expand
  • 1. Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China;2. Research Center for Bone Trauma Diseases, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China;3. Physical Education Institute of Southwest Medical University, Luzhou 646000, Sichuan Province, China;4. Department of Rehabilitation Yibin Integrated Traditional Chinese and Western Medicine Hospital, Yibin 644100, Sichuan Province, China;5. College of Integrated Chinese and Western Medicine of Southwest Medical University, Luzhou 646000, Sichuan Province, China

Received date: 2022-12-13

  Online published: 2023-08-02

摘要

目的    比较数字优化设计导航模板虚拟模型和3D打印模型之间的差异。  方法    收集2018年1月至2022年10月就诊西南医科大学附属中医医院的80名肩锁关节脱位患者的肩关节CT图像(37名女性和43名男性患者),将其CT图像导入Mimics软件,建立虚拟与真实导航骨隧道,设计并打印80个包括锁骨和肩胛骨在内的肩关节,分别测量虚拟与真实导航骨隧道的10个相关参数。  结果    两条骨隧道在9个参数上没有统计学差异(P>0.05),喙突针点到喙突尖的长度(OQ)有统计学差异(P<0.05)。女性患者的所有测量值低于男性(P<0.01)。  结论    数字优化设计导航模板的的虚拟模型具有与3D打印模型相似的准确性,可用于临床肩锁关节脱位需喙锁韧带重建术治疗的患者进行骨隧道定位。

本文引用格式

张磊, 王锐涵, 唐自慧, 易刚, 周鑫 . 数字优化设计在喙锁韧带重建术中骨隧道精准定位的应用[J]. 中国临床解剖学杂志, 2023 , 41(4) : 385 -389 . DOI: 10.13418/j.issn.1001-165x.2023.4.03

Abstract

Objective    To compare the differences between the virtual model of the digital optimization design navigation template and the real model of 3D printing.    Methods    Shoulder CT images were collected from 80 patients (37 women and 43 men) from January 2018 to October 2022. The patient’s CT images were imported into Mimics software to create virtual and real navigation bone tunnels. The 10 parameters were measured for virtual and real navigator bone tunnels.    Results    We designed and printed 80 shoulder joints including collarbones and shoulder blades. There was no statistically significant difference in 9 parameters (P>0.05) between the two bone tunnels, but there was a statistically significant difference in OQ (the length of the coracoid needlepoint to the coracoid tine)(P<0.05). All measurements were lower in female patients than in male patients (P<0.01).   Conclusions   The virtual model of digital optimization design has similar accuracy to the real model of 3D printing. In clinical practice, patients with acromioclavicular dislocation requiring coracoclavicular ligament reconstruction can try to locate bone tunnels using a virtual model of the digitally optimized design navigation template.

参考文献

[1] Lee S, Bedi A. Shoulder acromioclavicular joint reconstruction options and outcomes[J]. Curr Rev Musculoskelet Med, 2016, 9(4): 368-377. DOI: 10.1007/s12178-016-9361-8.
[2] Moatshe G, Kruckeberg BM, Chahla J, et al. Acromioclavicular and coracoclavicular ligament reconstruction for acromioclavicular joint instability: a systematic review of clinical and radiographic outcomes[J]. Arthroscopy, 2018, 34(6): 1979-1995. DOI: 10.1016/j.arthro. 2018. 01.016.
[3] Struhl S, Wolfson TS. Continuous loop double endobutton recon- struction for acromioclavicular joint dislocation[J]. Am J Sports Med, 2015, 43(10): 2437-44. DOI: 10.1177/0363546515596409.
[4] Grantham C, Heckmann N, Wang L, et al. A biomechanical assessment of a novel double endobutton technique versus a coracoid cerclage sling for acromioclavicular and coracoclavicular injuries[J]. Knee Surg Sports Traumatol Arthrosc, 2016, 24(6): 1918-1924. DOI: 10.1007/s00167-014-3198-8.
[5] 潘昭勋, 杜德凯, 张洪等. 三种Endobutton术式重建喙锁韧带术后稳定性的生物力学对比研究[J]. 中国临床解剖学杂志, 2017, 35(1):74-77. DOI: 10.13418/j.issn.1001-165x.2017.01.015.
[6] Banffy MB, Uquillas C, Neumann JA, et al. Biomechanical evaluation of a single- versus double-tunnel coracoclavicular ligament reconstruction with acromioclavicular stabilization for acromioclavi cular joint injuries[J]. Am J Sports Med, 2018, 46(5): 1070-1076. DOI: 10.1177/0363546517752673.
[7] Milewski MD, Tompkins M, Giugale JM, et al. Complications related to anatomic reconstruction of the coracoclavicular ligaments[J]. Am J Sports Med, 2012, 40(7): 1628-1634. DOI: 10.1177/036354651244 5273.
[8] Martetschläger F, Horan MP, Warth RJ, et al. Complications after anatomic fixation and reconstruction of the coracoclavicular ligaments[J]. Am J Sports Med, 2013, 41(12): 2896-2903. DOI: 10.1177/036354 6513502459.
[9] Campbell ST, Heckmann ND, Shin SJ, et al. Biomechanical evaluation of coracoid tunnel size and location for coracoclavicular ligament reconstruction[J]. Arthroscopy, 2015, 31(5): 825-830. DOI: 10.1016/j.arthro.2014.11.037.
[10] Ferreira JV, Chowaniec D, Obopilwe E, et al. Biomechanical evaluation of effect of coracoid tunnel placement on load to failure of fixation during repair of acromioclavicular joint dislocations[J]. Arthroscopy, 2012, 28(9): 1230-1236. DOI: 10.1016/j.arthro. 2012. 02. 004.
[11] Ranne JO, Kainonen TU, Lehtinen JT, et al. Arthroscopic coracoclavicular ligament reconstruction of chronic acromioclavicular dislocations using autogenous semitendinosus graft: a two-year follow-up study of 58 patients[J]. Arthrosc Sports Med Rehabil, 2020, 2(1): e7-e15. DOI: 10.1016/j.asmr.2019.10.003.
[12] Grantham C, Heckmann N, Wang L, et al. A biomechanical assessment of a novel double endobutton technique versus a coracoid cerclage sling for acromioclavicular and coracoclavicular injuries[J]. Knee Surg Sports Traumatol Arthrosc, 2016, 24(6): 1918-1924. DOI: 10.1007/s00167-014-3198-8.
[13] Xiong C, Lu Y, Wang Q, et al. Anatomical principles for minimally invasive reconstruction of the acromioclavicular joint with anchors[J]. Int Orthop, 2016, 40(11): 2317-2324. DOI: 10.1007/s00264-016-3283-3.
[14] Celik H, Chauhan A, Flores-Hernandez C, et al. Sagittal orientation of coracoclavicular ligament reconstruction affects the stability of surgical repair[J]. J Shoulder Elbow Surg, 2020, 29(9): 1901-1911. DOI: 10.1016/j.jse.2019.11.034.
[15] Zhang L, Xiong L, Zhou X, et al. Computed tomography-based determination of the optimal locations of bone tunnels for coracoclavicular ligament reconstruction[J]. Orthop Surg, 2022, 14(10): 2692-2700. DOI: 10.1111/os.13459.
文章导航

/