跟骨骨折畸形愈合的数字化虚拟重建及在矫形手术设计中的初步应用
收稿日期: 2013-11-22
网络出版日期: 2014-06-04
基金资助
广州市科技计划项目（2012Y2-00023）
The preliminary application of digital technology in the treatment of calcaneusmalunion
Received date: 2013-11-22
Online published: 2014-06-04
目的 探讨跟骨骨折畸形愈合的数字化虚拟重建的技术方法及其在矫形手术设计中应用的可行性。 方法 利用跟骨骨折畸形愈合病例患侧、健侧足踝部CT扫描图像及其数据收集，应用Mimics14.0软件进行三维重建，在重建出三维数字化模型及相关测量基础上，进行虚拟截骨及内固定等手术设计，并将虚拟截骨后的相关解剖学参数与健侧进行对比及拟合，据此进行手术治疗。 结果 重建出跟骨骨折畸形愈合的三维数字化可视模型，制备出相应的3D实物模型，可进行跟骨骨折畸形愈合相关解剖学参数的测量，可在个人计算机上初步实现截骨、内固定等矫形手术设计的可视化与可操作化。 结论 数字化虚拟重建技术能够为跟骨骨折畸形愈合的术前判断、临床诊治方式的选择等提供更为精准的解剖学及影像学依据, 并可望用于跟骨畸形愈合截骨治疗手术的设计。
梅刚 , 吴卫东 , 欧阳钧 , 金丹 , 付苏 , 邹振吕 . 跟骨骨折畸形愈合的数字化虚拟重建及在矫形手术设计中的初步应用[J]. 中国临床解剖学杂志, 2014 , 32(3) : 243 -247 . DOI: 10.13418/j.issn.1001-165x.2014
Objective To explore the virtual reconstruction technique of calcaneal malunion digitization and the feasibility of the method applied in the design of orthopedic surgery. Methods CT scan images of ipsilateral, contralateral foot and ankle of calcaneal malunion cases were imported to Mimics14.0 for reconstruction of the 3D model. on the basis of the reconstruction and measurement of 3D model, virtual osteotomy and digital fixation surgery were designed. After the digital surgery, anatomical parameters were compared to ipsilateral calcaneus. if the results are acceptable, then surgery was operated. Results 3D visualization model of the calcaneal malunion was constructed and anatomical parameters were measured and then 3D physical model was also printed by rapid prototyping machine. Personal computer could be used to perform virtual osteotomy and internal fixation. Conclusions Digital virtualized reconstructive technique could be used to provide precisely the anatomical and radiological data for judgment of the calcaneal malunion and decision of clinical diagnosis and treatment methods, and it also holds great promise for preoperative design of calcaneal malunion surgery.
[1] 俞光荣，梅炯，朱辉，等. 跟骨丘部重建距下关节融合治疗跟骨骨折严重畸形愈合
[J]. 中华骨科杂志, 2004, 24(1):11-14.
[2] 周军杰，俞光荣，曹成福，等. 距下关节融合与跟骨丘部矫形术治疗严重跟骨骨折畸形愈合
[J]. 中国修复重建外科杂志, 2007, 21(3):285-288.
[3] 王冰，李涛，朱裕成，等. 跟骨前部与载距突关系的解剖学研究及其临床意义
[J]. 中国临床解剖学杂志, 2012, 30(2):131-135.
[4] Zeman P, Zeman J, Matejka J, et al.
[Long-term results of calcaneal fracture treatment by open reduction and internal fixation using a calcaneal locking compression plate from an extended lateral approach]
[J]. Acta Chir Orthop Traumatol Cech, 2008, 75(6):457-464.
[5] Banerjee R, Saltzman C, Anderson RB, et al. Management of calcaneal malunion
[J]. J Am Acad Orthop Surg, 2011, 19(1):27-36.
[6] Brown GA, Willis MC, Firoozbakhsh K, et al. Computed tomography image-guided surgery in complex acetabular fractures
[J]. Clin Orthop Relat Res, 2000， (370):219-226.
[7] Rouleau DM, Sandman E, van Riet R, et al. Management of fractures of the proximal ulna
[J]. J Am Acad Orthop Surg, 2013, 21(3):149-160.
[8] Rydberg J, Buckwalter KA, Caldemeyer KS, et al. Multisection CT: scanning techniques and clinical applications
[J]. Radiographics, 2000, 20(6):1787-1806.
[9] Rangarajan V. Three dimensional (3D) CT reconstruction in cancer imaging
[J]. Indian J Med Res, 2013, 137(1):10-11.
[10] 金丹，王丹，苏秀云，等. 踝关节骨折数字化虚拟手术设计系统的建立及其初步临床应用
[J]. 中国骨与关节损伤杂志, 2009, 24(10):880-883.
[11] Wang X, Schroder HC, Feng Q, et al. The deep-sea natural products, biogenic polyphosphate (Bio-PolyP) and biogenic silica (Bio-Silica), as biomimetic scaffolds for bone tissue engineering: fabrication of a morphogenetically-active polymer
[J]. Mar Drugs, 2013, 11(3):718-746.
[12] 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.
/
| 〈 |
|
〉 |
京ICP备08002354号-3
