3D打印导板在肱骨髓内钉进钉点定位中的应用

发布时间：2018-02-26 00:30

本文关键词： 顺行肱骨髓内钉数字化设计 3D打印技术进钉点　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:1、初步学习与掌握医学数字化设计结合3D打印技术;2、探索研究3D打印导板在辅助顺行肱骨髓内钉置钉过程中的临床价值。方法:本研究收集了本院2016年1月至2017年1月于接受上肢CTA检查的13例患者的薄层CT扫描数据,并将其导入Mimics17.0软件中,进行三维重建及相应处理获得肱骨及肩关节骨性三维模型;应用拟合中心线等工具在肱骨近端确定其理想进钉点;把重建的模型导入Magic20软件中,分别以两套定位点方案设计导板:方案一以肱骨大小结节为定位点,方案二则以锁骨远端,肩峰及喙突为定位点;将设计好的导板及重建的肩关节运用3D打印技术制作出实体模型,并模拟导板辅助髓内钉导针穿刺;最后采用X线透视验证其穿刺效果。结果:13个病例均应用上述两个方案设计并打印导板,模拟穿刺均能顺利穿入髓腔。经过X线透视,髓钉导针也基本上都在髓腔的中心,并通过狭窄处中心。结论:数字化设计结合3D打印技术制作的导板能够辅助顺行肱骨髓内钉准确置钉,改变了传统凭借经验置钉模式,可避免反复盲穿。但需要进一步临床验证并改进。
[Abstract]:Objective: to explore the clinical value of 3D printing guide plate in the process of assisted anterograde humeral intramedullary nail placement. Methods: the clinical value of 3D printing guide plate in the process of assisted anterograde humeral intramedullary nail placement was investigated. Up to January 2017, thin slice CT scan data of 13 patients undergoing upper limb CTA examination, The 3D model of humerus and shoulder bone is obtained by three dimensional reconstruction and corresponding processing, and the ideal point of nail is determined in the proximal humerus by means of fitting centerline, and the reconstructed model is imported into Magic20 software. Two sets of location-point schemes were used to design the guide plate: one was based on the humeral nodule and the other was based on the distal clavicle, acromium and coracoid process. The designed guide plate and the reconstructed shoulder joint were used to make the solid model by 3D printing technology, and the guide plate was simulated to assist the puncture of the intramedullary nail guide needle. Finally, X-ray fluoroscopy was used to verify the puncture effect. Results: all the 13 cases were designed and printed the guide plate with the two schemes mentioned above, and simulated puncture could enter the medullary cavity smoothly. After X-ray fluoroscopy, the needle was basically in the center of the medullary cavity. Conclusion: the guide plate made by digital design combined with 3D printing technology can assist in accurate nail placement of the anterograde humeral intramedullary nail, which changes the traditional experience nailing mode. Repeated blind puncture can be avoided, but further clinical validation and improvement are needed.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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