基于数字化设计和3D打印胫骨近端骨折内固定的关键技术

发布时间：2018-01-24 18:56

本文关键词： 胫骨骨折骨折固定术内治疗计算机辅助组织工程骨科植入物数字化骨科胫骨近端骨折内固定数字化设计 D打印标准件福建省自然科学基金　出处：《中国组织工程研究》2016年26期 　论文类型：期刊论文

【摘要】：背景:前期实验已经完成了胫骨近端骨折三维重建复位及数字钢板设计、胫骨近端接骨板标准件库的建立以及3D打印后的手术模拟。目的:在前期研究基础上,探讨数字化设计结合3D打印模型进行标准件库接骨板、螺钉在胫骨近端骨折中导航内固定置入方法的可行性及准确性。方法:采集20例临床胫骨近端骨折患者连续薄层CT扫描的Dicom格式图像,分别导入Mimics软件予以三维重建、骨折复位。从标准件库中选择接骨板、螺钉虚拟内固定,设计带钉道的导航模块。3D打印骨骼、接骨板、导航模块,进行骨骼模型内固定手术,导航放置螺钉、接骨板,观察导航模块卡位、板钉位置情况,以术后外观、CT扫描评价效果。结果与结论:20例骨骼模型术后均行CT扫描重建,结合外观,显示接骨板位置、螺钉的进钉点,进钉方向、长度、直径均与Mimics软件中模拟预设的一致。导航模块和相对应的胫骨近端骨性结构贴合紧密,嵌合度良好,在应用时卡位及稳定性良好,可以很好指引接骨板放置、螺钉置入。提示:在导航模块的辅助下,胫骨近端骨折标准件库接骨板内固定置入准确率高,基于数字化设计和3D打印的标准件库接骨板数字化内固定技术有望良好实现骨科内固定物置入导航。
[Abstract]:Background: Three-dimensional reconstruction reduction and digital plate design for proximal tibial fractures have been completed in previous experiments. The establishment of standard parts library of proximal tibial plate and the operation simulation after 3D printing. Objective: based on the previous research, the digital design combined with 3D printing model for standard parts library plate was discussed. The feasibility and accuracy of navigation internal fixation in proximal tibial fractures. Methods: Dicom format images of 20 patients with proximal tibial fractures were collected. Three dimensional reconstruction and fracture reduction were carried out with Mimics software respectively. The bone-plate was selected from the standard parts library and the screw virtual internal fixation was used to design the navigation module .3D printing bone with the nail path and the bone-plate. Navigation module, bone model internal fixation surgery, navigation screw placement, bone plate, observation of navigation module clamp, plate nail position, in order to postoperative appearance. Results and conclusion CT scan reconstruction was performed in 20 cases of bone model after operation. Combined with appearance, the position of bone plate, the point of screw entry, the direction of screw entry and the length of screw were displayed. The diameters are consistent with the simulated presupposition in Mimics software. The navigation module and the corresponding proximal tibial bone structure are closely aligned and the chimera degree is good. It can guide the plate placement and screw placement well. It is suggested that with the help of navigation module, the accuracy of internal fixation of proximal tibial fracture standard parts library is high. The digital internal fixation technology based on digital design and 3D printing for standard parts library connectors is expected to achieve good navigation of orthopedic internal fixation.
【作者单位】：莆田学院附属医院骨科;
【基金】：福建省莆田市科技计划课题(2013S03(6)) 福建省莆田学院科研基金项目(2014027) 福建省自然科学基金项目(2016J01483) 福建省卫生和计划生育委员会卫生系统中青年骨干人才培养项目(2014-ZQN-JC-39)~~
【分类号】：R687.3;TP391.73
【正文快照】： 采集胫骨近端骨折连续薄层CT扫描的Dicom格式图像三维重建、骨折复位虚拟内固定、设计导航模块骨骼模型内固定手术导入Mimics软件标准件库中选择螺钉接骨板3D打印通过CT扫描验证接骨板位置,螺钉的进钉点、走向、长度、直径是否与Mimics软件中模拟的最佳参数一致文章快速阅读:

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