南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (07): 1014-.

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3D数字骨科技术在髋臼骨折治疗中的应用

李宝丰,章莹,邰国良,代元元,谢会斌,郭晓泽,朱昌荣,王非   

  • 出版日期:2016-07-20 发布日期:2016-07-20

Application of 3D digital orthopedic techniques in treatment of acetabular fracture

  • Online:2016-07-20 Published:2016-07-20

摘要: 目的探讨3D数字骨科技术在髋臼骨折治疗中的应用价值及其疗效。方法回顾分析2009年1月~2013年12月采用3D 数字骨科技术进行辅助治疗的50例髋臼骨折患者资料,术前行薄层CT扫描获取骨盆二维数据,导入Mimics软件重建三维模 型,计算机辅助分析髋臼骨折情况并进行模拟复位,快速成型技术制出与实体1∶1大小的骨盆模型。根据模型对髋臼骨折做出 明确的诊断、分型,指导手术治疗。结果术中所见骨折及移位情况与术前三维重建图像及快速成型模型非常相似,术前模拟缩 短了手术时间,减少了术中出血量。所有患者随访6~24个月,骨折复位情况根据Matta影像学评分标准:解剖复位41例,复位满 意9例;髋关节功能按照Harris评分标准,优32例,良12例,可6例,优良率88%。结论CT扫描三维重建、计算机辅助分析和模 拟骨折复位,快速成型技术能直观、精确地显示髋臼骨折的立体形态和各解剖结构的空间关系,对髋臼骨折的诊断、分型及治疗 具有良好的指导作用。

Abstract: Objective To evaluate the therapeutic effect of three-dimensional digital orthopedic techniques in treatment of acetabular fractures. Methods We retrospectively analyzed 50 cases of acetabular fracture treated between March, 2007 and December, 2013. The lamellar CT scanning data were imported into Mimics software, and 3D anatomical models of the pelvic and proximal femur were reconstructed. Computer-assisted analysis was carried out to understand the condition of fractures and simulate fracture reduction. The pelvic models were manufactured by rapid prototyping technique for definite diagnosis and typing of acetabular fractures and subsequent surgical treatment. Results Three-dimensional reconstruction images and rapid prototyping pelvic models faithfully represented the findings in operations. Preoperative simulation of the operation shortened the time of operation and reduced the volume of bleeding in the operation. All the patients were followed up for 6 to 24 months. According to Matta imaging score, anatomical reduction was achieved in 41 cases and satisfactory reduction in 9 cases. According to the Harris functional criteria, 32 patients had excellent, 12 had good and 6 had acceptable outcomes with a rate of excellent and good outcomes of 88%. Conclusion Three-dimensional digital orthopedic techniques allow accurate display of the acetabulum and the spatial relation of the anatomic structures to assist in fracture diagnosis, typing and treatment.