【摘要】 目的利用数字化三维重建与逆向工程技术设计、制备下胫腓联合损伤固定数字化导向模板,并在临床初步应用。方法自2006年1月～2009年1月,选择5例不合并腓骨骨折的下胫腓联合分离患者,进行双踝关节连续CT扫描,将原始数据导入Mimics软件,三维重建下胫腓联合模型,以STL格式保存,导入Imageware10.0软件,定位三维参考平面,利用RE原理、以AO内固定原则为基础设计下胫腓联合固定螺钉的最佳进钉钉道,提取腓骨的表面解剖学形态及钉道模型,建立与其解剖学形态一致的数字化虚拟模板。通过激光RP技术生产出实物模板。手术时首先复位下下胫腓联合,将模板准确贴于患侧腓骨远端外侧,利用模板上预先制备的导向孔进行定位和置入螺钉。结果建立了下胫腓联合数字化模型以及制作个体化导航模板的方法,制备出的导向模板具有较好的匹配性,适用于下胫腓联合的固定,在临床初步应用中显示了良好的效果。结论采用数字化三维重建及逆向工程技术制备的固定导向模板下胫腓联合分离的固定提供了一种新的方法,具有一定的临床应用价值。更多还原

【Abstract】 Objective To design and prepare a new digitalized navigation template for fixation of inferior tibiofibular joint using three-dimensional reconstruction and reverse engineering techniques.Methods Five patients with inferior tibiofibular joint rupture without fibula fracture underwent three-dimensional CT scanning of the lower limbs.The image data were transferred into Mimics software,and after reconstruction of the three-dimensional models of inferior tibiofibular joint rupture and saving in.stl format,the three-dimensional models were imported into Imageware10.0 software to determine the three-dimensional plane of reference.The location of the optimal pedicle channel was defined using reverse engineering and AO internal fixation principle.The template was designed according to the anatomic features of the fibular surface,and the optimal pedicle channel and the template were overlapped as the navigational template,which was manufactured by rapid prototyping.The inferior tibiofibular joint was reduced and the template was placed distally on the external fibula,and the location for screw insertion was defined by the navigation template.Results and Conclusion The digitalized model of the inferior tibiofibular joint was established.The navigation template manufactured offered good compatibility and was applied successfully for fixation of the inferior tibiofibular joint.This approach provides a new means for fixation of ruptured inferior tibiofibular joint using the reverse engineering and digitized 3-dimensional reconstruction techniques.更多还原