CAJ | 학술논문

背景：一般而言，个体双侧的桡骨头解剖无显著性差异。桡骨头假体的应用属部分肘关节置换，其设计应满足肘关节解剖学和生物力学要求。为防止术后疼痛、假体松动等并发症发生，个体化定制桡骨头假体很有必要。 　　目的：基于健侧桡骨近端的CT数据，利用数字骨科技术体外计算机辅助设计定制患侧桡骨头假体。 　　方法：基于1例受试者左侧肘关节的CT扫描数据，应用Mimics 10.0和Geomagic studio 12软件逆向工程生成右侧桡骨头部实体文件，应用UG NX 8.0软件根据Mimics 10.0测量桡骨颈段参数计算机辅助设计假体柄和可选颈圈并组装头柄部，成功完成右侧桡骨头假体的体外定制。应用Mimics 10.0软件对6例受试者双侧肘关节CT扫描数据三维重建，测量比较双侧桡骨近端形态学参数，包括桡骨头的最大高度、桡骨头颈平面最小外直径、桡骨头颈平面髓腔最大内径和桡骨颈段髓腔长度，以验证基于一侧桡骨近端定制的另一侧桡骨头假体安装的匹配性。 　　结果：6例受试者的双侧桡骨近端各形态学参数误差均＜1 mm，依据健侧桡骨近端解剖参数设计定制的桡骨头假体患侧置换高精确度匹配。 　　结论：应用数字骨科技术体外辅助设计定制桡骨头假体科学可行，为假体的个体化制造提供新的方法。
배경：일반이언，개체쌍측적뇨골두해부무현저성차이。뇨골두가체적응용속부분주관절치환，기설계응만족주관절해부학화생물역학요구。위방지술후동통、가체송동등병발증발생，개체화정제뇨골두가체흔유필요。 　　목적：기우건측뇨골근단적CT수거，이용수자골과기술체외계산궤보조설계정제환측뇨골두가체。 　　방법：기우1례수시자좌측주관절적CT소묘수거，응용Mimics 10.0화Geomagic studio 12연건역향공정생성우측뇨골두부실체문건，응용UG NX 8.0연건근거Mimics 10.0측량뇨골경단삼수계산궤보조설계가체병화가선경권병조장두병부，성공완성우측뇨골두가체적체외정제。응용Mimics 10.0연건대6례수시자쌍측주관절CT소묘수거삼유중건，측량비교쌍측뇨골근단형태학삼수，포괄뇨골두적최대고도、뇨골두경평면최소외직경、뇨골두경평면수강최대내경화뇨골경단수강장도，이험증기우일측뇨골근단정제적령일측뇨골두가체안장적필배성。 　　결과：6례수시자적쌍측뇨골근단각형태학삼수오차균＜1 mm，의거건측뇨골근단해부삼수설계정제적뇨골두가체환측치환고정학도필배。 　　결론：응용수자골과기술체외보조설계정제뇨골두가체과학가행，위가체적개체화제조제공신적방법。
Background:Generally, there is no significant difference between the anatomies of radial head at both sides of an individual. Since the application of radial head prosthesis is a kind of partial replacement of the elbow, the design of the prosthesis should satisfy the requirements of both elbow joint anatomy and biomechanics. In order to prevent the complications of post-operative pain, prosthesis loosening, etc., it is necessary to customize the radial head prosthesis. Objective:Based on the proximal radius CT data scanned from the healthy side, to design the custom-made radial head pros-thesis in vitro with the aid of digital orthopaedic technology. Methods:Based on the CT scanned data of the left elbow of a subject, the Mimics 10.0 and Geomagic studio 12 reverse en-gineering software were adopted to generate the entity files of the right radial head. According to the parameters of the right radial neck measured by Mimics 10.0, the UG NX 8.0 software was applied to design the stem and optional collars of the prosthesis with the aid of computer, and assemble the head with the stem. The right radial head prosthesis was custom-de-signed successfully in vitro. CT scanned data of the bilateral elbow joints of 6 subjects were compared to verify the match-ing of the custom-made prosthesis and the injured elbow. The morphological parameters of the bilateral proximal radius of these 6 subjects were measured and compared with the measurement tool of Mimics 10.0 software, which included the maxi-mum height of radial head, the minimum outer diameter on the plane of radial head and neck, the maximum diameter of medullary cavity on the plane of radial head and neck, and the length of marrow cavity in the radial cervical segment. Results:Errors of the morphological parameters were all less than 1 mm. It indicated that the radial head prosthesis custom-designed based on the anatomical parameters of the healthy side can accurately match the injured side. Conclusions: Designing the custom-made radial head prosthesis in vitro with the aid of digital orthopaedic technology is sci-entific and feasible. It has provided a new way to customize the prosthesis for each individual.