3D打印计算机虚拟辅助技术在髋臼骨折术前规划中的应用

发布时间：2018-01-26 16:07

本文关键词： D打印计算机辅助术前规划髋臼骨折疗效　出处：《南方医科大学学报》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨3D打印技术计算机辅助下虚拟手术模拟在髋臼骨折术前规划中应用的可行性和有效性。方法回顾性分析2013年9月~2015年12月行手术治疗并获完整随访的53例髋臼患者资料。其中19例患者应用CT三维重建、计算机虚拟复位内固定、3D模型打印、个性化手术模拟,术中按术前规划手术(3D组);34例患者行术前常规检查,术中经验性手术(常规组)。记录两组患者的术中出血量、围手术期输血量、术中透视次数、手术时间、骨折复位质量等。并应用MIMICS软件的三维叠加功能将术前规划与术后结果进行比较分析。结果所有患者均顺利完成手术,3D组术中出血量、围手术期输血量、术中透视次数少,手术时间缩短,以上项目两组间比较差异均有统计学意义(P0.05)。术后根据Matta评分标准评定骨折复位质量:3D组与常规组优良率分别为[94.7%(18/19)∶82.4%(28/34)];末次随访时髋关节功能根据改良Merle D’AubignePostel评分标准:优良率分别为[89.5%(17/19)∶85.3%(29/34)],以上项目两组间比较差异均无统计学意义(P0.05);3D组术前术后CT数据MIMICS软件三维叠加显示实际内固定放置与术前设计吻合度较高。结论 3D打印技术计算机辅助下虚拟手术对髋臼骨折进行术前规划是可行的、精确的,能有效提高手术效率。
[Abstract]:Objective to investigate the virtual surgery 3D printing technology by computer simulation in the application feasibility of preoperative planning and effectiveness of acetabular fractures. Methods 53 cases were analyzed retrospectively in September 2013 ~2015 December underwent surgical treatment and followed up the acetabulum. 19 patients were treated with CT 3D reconstruction, virtual reduction and internal fixation, 3D model printing, personalized surgical simulation according to preoperative planning, intraoperative (3D group); 34 patients underwent routine preoperative examination, intraoperative surgical experience (conventional group). The bleeding of two groups of patients during operation, perioperative blood transfusion, intraoperative fluoroscopy times, operation time, fracture reduction quality etc. three-dimensional overlay function and the application of MIMICS software to preoperative planning and postoperative results were compared and analyzed. Results all patients were successfully completed the operation, the amount of bleeding in the group 3D, perioperative blood transfusion, intraoperative fluoroscopy times, hand The operation time is shortened, more than two projects a significant difference between the two groups (P0.05). The postoperative Matta score according to the evaluation standard of fracture reduction quality: 3D group and routine group were excellent and good rate of [94.7% (18/19): 82.4% (28/34)]; at the end of the follow-up of hip joint function according to the modified Merle D AubignePostel score criteria: excellent rate was [89.5% (17/19): 85.3% (29/34)], above project between the two groups showed no significant difference (P0.05); group 3D, preoperative and postoperative CT data MIMICS software three-dimensional overlay display actual fixation placement and preoperative design kiss high heterozygosity. Conclusion 3D printing technology virtual surgery computer aided preoperative planning of the acetabular fracture is feasible and accurate, and can effectively improve the operation efficiency.

【作者单位】：南方医科大学第三附属医院//广东省骨科研究院骨科;青海省人民医院骨科;
【基金】：广东省科技计划项目(2014A020212176,2014B090901055,2016B090916003) 广东省医学科学技术研究基金(A2016521)
【分类号】：R687.3;TP391.73
【正文快照】： 髋臼骨折是以高能量损伤为主的关节内骨折,常合并毗邻脏器、重要血管神经损伤,是创伤骨科最为复杂的骨折之一。由于位置深入,周围解剖关系复杂,骨性结构不规则等生理特点,使得髋臼骨折的治疗颇为棘手。虽然并不是所有的骨折都需要通过手术治疗来达到满意的复位,但发生在身体

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