【作者】 陈国立；

【导师】 徐杰；

【作者基本信息】 福建医科大学 ， 外科学， 2011， 硕士

【摘要】 目的:运用医学三维重建软件Mimics结合机械制图软件Solidworks,探讨胫骨平台后侧骨折的数字化内固定植入物的设计方法。方法:采用17侧成人尸体下肢标本为实验材料,主要实验步骤包括标本制作、高速薄层CT扫描、三维重建、预定植入钢板部位的三维数据测量、Solidworks零件文件的绘制、虚拟骨折复位、虚拟钢板内固定及观察效果。下肢标本经胫骨平台后内侧及后外侧手术入路暴露造模部位,以骨钻、克氏针、骨刀及骨锤等器械实施胫骨平台后内侧及后外侧Khan骨折造模各2侧,骨折片以凝胶固定,余13侧下肢标本以铁丝编号标记,进行高速薄层CT扫描,扫描层距0.625mm,扫描数据以光盘输出至Mimics 11.0,设定阈值并针对Mask文件进行编辑,以Optimal、Shell Reduction 1为参数进行三维重建,针对初步重建的三维模型进行一定的表面光滑处理以适应三维测量。在胫骨平台后侧预定植入钢板的位置按照骨性标记划分成不同的平面,以Mimics的3D测量工具对这些平面进行3D长度的标记,根据这些标记进行三维角度的测量。在Solidworks 2008 SPO中根据测量数据进行内固定钢板以及螺钉的绘制。在Mimics中,以Reposition命令,针对骨折块的三维模型进行3D的移动及转动,完成虚拟骨折复位。在Mimics中加载钢板及螺钉的Stl格式文件,以Reposition命令将钢板及螺钉移动至预定植入位置,完成虚拟内固定,观察内固定效果,如有必要,对钢板的Solidworks零件文件进行修改。结果:所有标本及2种骨折模型均进行了CT扫描;三维重建、虚拟骨折复位;根据钢板设计及植入要求,实施三维模型3D的长度及角度测量;根据3D测量数据,完成内固定钢板及螺钉的Solidworks零件文件的绘制;在Mimics中,均完成标本、钢板及螺钉的虚拟内固定;显示虚拟内固定解剖复位,效果良好。结论:1运用个人电脑、医学三维重建软件Mimics结合机械制图软件Solidworks,可以进行数字化内固定植入物的设计;2本课题为数字骨科学内固定器械设计提供一定参考。更多还原

【Abstract】 Objective: To investigate the procedures of digital design for fixation implant in dorsal tibial plateau fractures by medical 3-D reconstruction software Mimics and mechanical drafting program Solidworks.Methods: Lower extremities of 17 Adult corpses were selected for experimental materials, main steps include specimen making, high-speed thin layer CT scans, three-dimensional reconstruction, 3-D data measurement, drafting of Solidworks section, theoretical reduction of the fracture, internal fixation with steel plate and consequence analysis. Molding section of lower extremities were exposed by approaching to posteromedial or dorsolateral tibial plateau, apparatus include bone drill,Kirschner wire, osteotome and bone mallet were used to make mold of tibial plateau fractures, specimen were classified into 2 categories by Khan classification--posteromedial and dorsolateral side. Fragments were fixed by adhesive gel, the rest of 13 lower extremities were identified by steel wire. High-speed thin layer CT scans carried out consequently with scanning layer 0.625mm, all data were collected to Mimics 11.0 via disc, files of mask were compiled after threshold value set up, and three-dimensional reconstruction was through by parameters of optimal, shell reduction 1. Preliminary 3-D moldings were polished for further measurement. Various sections were noted by osseous markers on the rear site of tibial plateau where steel plate are scheduled to be implanted. Mimics was applied to measure the 3-D length and 3-D angle on the scale in those sections. Steel plates and screws were drafted by Solidworks 2008 SPO in accordance with previous data. Theoretical reduction of the fracture achieved by shifting or moving 3-D model under Reposition instruction in Mimics program, then digital internal fixation was accomplished through moving steel plate and screw to the scheduled site under Reposition instruction after stl files uploaded in Mimics program, consequence analysis was done as followed, Solidworks section will be amended when necessary according to the consequence analysis.Result: CT scans, three-dimensional reconstruction, theoretical reduction of the fracture have been carried out smoothly in all cases and 2 kinds of fracture molds. And the measurement of length or angle in 3-D mold was done in accordance with the design and implantation of steel plate. The drafting of Solidworks sections and internal fixation was achieved by 3-D measurement data. What’s more, the visual internal fixation of sample, steel plate and screw was carried out in the Mimics. The consequence analysis shows anatomical reduction and excellent internal fixation.Conclusion:1. The design of digital implantation fixation can be carried out by using PC, medical three-dimensional reconstruction software Mimics and Solidwork. 2. Our project may provide relevant evidence for orthopedic instruments development.更多还原