中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2011年
12期
1135-1138
,共4页
孟国林%刘建%胡蕴玉%裴国献%袁志%颜永年%熊卓%孙龙%高嘉锴%杨鹏
孟國林%劉建%鬍蘊玉%裴國獻%袁誌%顏永年%熊卓%孫龍%高嘉鍇%楊鵬
맹국림%류건%호온옥%배국헌%원지%안영년%웅탁%손룡%고가개%양붕
胫骨%骨折%成像,三维,快速成型
脛骨%骨摺%成像,三維,快速成型
경골%골절%성상,삼유,쾌속성형
Tibia%Fraetures%Imaging,three-dimensional%Rapid-prototyping
目的 探讨快速成型技术制备的模型在胫骨平台复杂骨折手术方案制定中的指导作用. 方法 2006年11月至2010年11月收治16例胫骨平台复杂患者,男10例,女6例;年龄27～68岁,平均39岁.术前根据X线片和CT进行AO分型;41B2.2型4例,41B3.2型3例,41B3.3 型2例,41C2.1型1例,41C3.1型2例,41C3.2型2例,41C3.3型2例.术前均进行三维螺旋CT扫描,所得数据经转化输入决速成型机,制备出了1:1等大的快速成型胫骨平台骨折模型,明确骨折类型并指导制定手术方案,术后随访了解骨折愈合与患膝功能情况. 结果 2例患者骨折分型由AO41B2.2型修正为41B3.1型,1例患者骨折分型由41C2.1型修正为41C3.1型.模型上进行了损伤机制的分析和手术方案的制定.所有患者术后获9～22个月(平均14个月)随访,骨折均获骨性愈合,愈合时间4～6个月(平均4.7个月),术后膝关节功能参照改良HSS膝关节评分系统评定:优11例,良3例,可2例,优良率为87.5％.结论 采用快速成型技术制备的1:1等大胫骨平台骨折模型使骨折伤情更直观,骨折分型更加准确;可根据骨折模型制定手术方案,并可对内固定钢板进行预先塑形,对复杂类型的骨科手术方案的制定有较强的指导作用.
目的 探討快速成型技術製備的模型在脛骨平檯複雜骨摺手術方案製定中的指導作用. 方法 2006年11月至2010年11月收治16例脛骨平檯複雜患者,男10例,女6例;年齡27～68歲,平均39歲.術前根據X線片和CT進行AO分型;41B2.2型4例,41B3.2型3例,41B3.3 型2例,41C2.1型1例,41C3.1型2例,41C3.2型2例,41C3.3型2例.術前均進行三維螺鏇CT掃描,所得數據經轉化輸入決速成型機,製備齣瞭1:1等大的快速成型脛骨平檯骨摺模型,明確骨摺類型併指導製定手術方案,術後隨訪瞭解骨摺愈閤與患膝功能情況. 結果 2例患者骨摺分型由AO41B2.2型脩正為41B3.1型,1例患者骨摺分型由41C2.1型脩正為41C3.1型.模型上進行瞭損傷機製的分析和手術方案的製定.所有患者術後穫9～22箇月(平均14箇月)隨訪,骨摺均穫骨性愈閤,愈閤時間4～6箇月(平均4.7箇月),術後膝關節功能參照改良HSS膝關節評分繫統評定:優11例,良3例,可2例,優良率為87.5％.結論 採用快速成型技術製備的1:1等大脛骨平檯骨摺模型使骨摺傷情更直觀,骨摺分型更加準確;可根據骨摺模型製定手術方案,併可對內固定鋼闆進行預先塑形,對複雜類型的骨科手術方案的製定有較彊的指導作用.
목적 탐토쾌속성형기술제비적모형재경골평태복잡골절수술방안제정중적지도작용. 방법 2006년11월지2010년11월수치16례경골평태복잡환자,남10례,녀6례;년령27～68세,평균39세.술전근거X선편화CT진행AO분형;41B2.2형4례,41B3.2형3례,41B3.3 형2례,41C2.1형1례,41C3.1형2례,41C3.2형2례,41C3.3형2례.술전균진행삼유라선CT소묘,소득수거경전화수입결속성형궤,제비출료1:1등대적쾌속성형경골평태골절모형,명학골절류형병지도제정수술방안,술후수방료해골절유합여환슬공능정황. 결과 2례환자골절분형유AO41B2.2형수정위41B3.1형,1례환자골절분형유41C2.1형수정위41C3.1형.모형상진행료손상궤제적분석화수술방안적제정.소유환자술후획9～22개월(평균14개월)수방,골절균획골성유합,유합시간4～6개월(평균4.7개월),술후슬관절공능삼조개량HSS슬관절평분계통평정:우11례,량3례,가2례,우량솔위87.5％.결론 채용쾌속성형기술제비적1:1등대경골평태골절모형사골절상정경직관,골절분형경가준학;가근거골절모형제정수술방안,병가대내고정강판진행예선소형,대복잡류형적골과수술방안적제정유교강적지도작용.
Objective To explore the role of rapid prototyping (RP) in the operation design for complicated fractures of tibial plateau. Methods Included in the present study were 16 patients with complex fracture of tibial plateau who had undergone preoperative 3-D CT scanning before surgery from November 2006 to November 2010.Their CT data were transformed and imported into a RP machine to pro duce RP models of tibial plateau fracture with a ratio of 1: 1.The RP models were used for classification of tibial plateau fractures by AO system and operation design. Results According to the RP models,the classification was modified from AO type 41B2.2 to AO type 41B3.1 in 2 cases and from AO type 41C2.1 toAO type 41C3.1 in one case.The RP models were also used to discuss fracture mechanisms and determine operation designs so that the following operation became simpler and less invasive.The follow-up period lasted from 3 to 22 months ( 14 months on average).All the 16 patients got bone union from 4 to 6 months.According to the Evanich criteria,the function of the knee joint was rated as exccllent in 11 patients,good in 3 and fair in 2,with a satisfactory rate of 87.5％. Conclusions RP models of complex tibial plateau fracture can help surgeons have a direct and clear visualization of the fracture to be treated.The RP models can make exact classification of the complex tibial fracture,and facilitate operation design,selection of in ternal fixation and preoperative remodeling of the steel plate to be used.
