CAJ | 학술논문

背景：桡骨远端骨折以掌侧锁定钢板治疗为主，但尚存在操作中难以判断钢板位置同腕关节面边缘的距离，可导致螺钉穿出关节面的并发症。关节镜或操作中透视各有利弊，缺乏简单易行且有效的关于钢板放置定位的方法。 　　目的：探索桡骨远端骨折掌侧锁定钢板的放置定位及计算机仿真在此治疗前规划的作用。 　　方法：收集20例成人桡骨CT断层数据，通过MIMICS软件建模，在MIMICS中装配桡骨和掌侧钢板，测量最佳的关节面边缘同钢板远排螺孔中心的距离，求其标准差及均值。将桡骨远端骨折患者33例分为2组，常规规划组治疗前常规X射线及CT阅片，计算机规划组治疗前根据计算机测量的数据辅助规划。 　　结果与结论：常用斜T型掌侧锁定钢板的安置安全区为：螺钉孔中心距关节面边缘均值男性为11.13 mm，女性为10.97 mm。计算机规划组患者治疗中透视次数及操作时间显著少于常规规划组(P<0.05)。提示计算机仿真技术可以有效确定桡骨远端掌侧钢板的适当位置，应用于治疗前规划中有助于减少老年骨折患者的透视及操作时间。
배경：뇨골원단골절이장측쇄정강판치료위주，단상존재조작중난이판단강판위치동완관절면변연적거리，가도치라정천출관절면적병발증。관절경혹조작중투시각유리폐，결핍간단역행차유효적관우강판방치정위적방법。 　　목적：탐색뇨골원단골절장측쇄정강판적방치정위급계산궤방진재차치료전규화적작용。 　　방법：수집20례성인뇨골CT단층수거，통과MIMICS연건건모，재MIMICS중장배뇨골화장측강판，측량최가적관절면변연동강판원배라공중심적거리，구기표준차급균치。장뇨골원단골절환자33례분위2조，상규규화조치료전상규X사선급CT열편，계산궤규화조치료전근거계산궤측량적수거보조규화。 　　결과여결론：상용사T형장측쇄정강판적안치안전구위：라정공중심거관절면변연균치남성위11.13 mm，녀성위10.97 mm。계산궤규화조환자치료중투시차수급조작시간현저소우상규규화조(P<0.05)。제시계산궤방진기술가이유효학정뇨골원단장측강판적괄당위치，응용우치료전규화중유조우감소노년골절환자적투시급조작시간。
BACKGROUND:Volar locking plate is the dominant treatment of distal radial fractures, but it is difficult to judge the distance between the plate position and the carpal articular surface, thus leading to screw penetration of the articular surface. Arthroscopy or operative perspective has their pros and cons, there is no simple and effective method of positioning the plate. OBJECTIVE:To find the optimal position of Volar LCP in distal radius fractures and explore the role of computer simulation in this treatment. METHODS:The CT data of the wrists in 20 adult patients were col ected to calculate 3D models of the radius by MIMICS software. 3D model of the LCP was calculated by UG in working station. The distance between the plate and the distal radius joint was measured by computer simulation, and the mean value was calculated. A total of 33 Patients with distal radial fractures were divided into two groups:conventional treatment group (regular X-ray and CT) and computer simulation group (preoperative plan based on the computer-measured data). RESULTS AND CONCLUSION:The safe distance between the screw center and the articular facet was 11.13 mm in males and 10.97 in females. The number of radiation and operating time were shortened significantly in computer simulation group (P<0.05). Experimental findings indicate that, computer simulation is a powerful tool to find the optimal position of volar LCP in the distal radius fractures. The time of the operation and X-ray fluoroscopy are also shortened significantly.