CAJ | 학술논문

目的：通过CT扫描尸体标本的方法探讨数字化技术辅助下利用自制的定位装置进行个性化人工肱骨头置换术的准确性及可行性。方法对10具双侧上肢尸体标本（包括肩、肘关节）进行CT扫描，利用数字化软件，根据CT扫描数据测量肱骨头高度及后倾角度；制造肱骨近端粉碎性骨折模型20例，运用自制的定位装置在人工肱骨头置换术中重建肱骨头的高度及后倾角度；术后再次测量并对数据进行统计学分析，比较术前术后相关参数的差异。结果20例模型在人工肱骨头置换术中使用自行研制的定位装置均可有效控制假体高度及后倾角度，手术前测得肱骨头高度平均为（28.57±2.38）cm，肱骨头后倾角平均为（23.0°±5.8°）（11.1°～28.7°）。术后假体高度（t＝0.185， P＞0.05）及后倾角度（t＝0.481，P＞0.05）与术前相比其差异无统计学意义。结论在人工肱骨头置换术中利用自制的定位装置，可根据健侧测量的数据重建患侧的肱骨头的高度和后倾角度，做到真正的个性化设计和精确的肩关节置换。
목적：통과CT소묘시체표본적방법탐토수자화기술보조하이용자제적정위장치진행개성화인공굉골두치환술적준학성급가행성。방법대10구쌍측상지시체표본（포괄견、주관절）진행CT소묘，이용수자화연건，근거CT소묘수거측량굉골두고도급후경각도；제조굉골근단분쇄성골절모형20례，운용자제적정위장치재인공굉골두치환술중중건굉골두적고도급후경각도；술후재차측량병대수거진행통계학분석，비교술전술후상관삼수적차이。결과20례모형재인공굉골두치환술중사용자행연제적정위장치균가유효공제가체고도급후경각도，수술전측득굉골두고도평균위（28.57±2.38）cm，굉골두후경각평균위（23.0°±5.8°）（11.1°～28.7°）。술후가체고도（t＝0.185， P＞0.05）급후경각도（t＝0.481，P＞0.05）여술전상비기차이무통계학의의。결론재인공굉골두치환술중이용자제적정위장치，가근거건측측량적수거중건환측적굉골두적고도화후경각도，주도진정적개성화설계화정학적견관절치환。
Objective To validate the accuracy and feasibility of the personalized humeral head replacement assisted with the digital technology by a cadaveric study .Methods The humeral length and the humeral head retroversion angle were measured by Mimics 14.01 according the preoperative CT data of 20 cadaver shoulders .20 comminuted proximal humeral fracture models were set up before the operation .A self-designed stereotaxic device was used for the humeral head prosthesis placement based on the humeral length and the humeral head retroversion angle which were measured by the digital technology preoperatively .Subsequently , the multi-slice spiral CT scan was performed to evaluate the accuracy of the placed prosthesis postoperatively .Results The humeral length and the humeral head retroversion angle could be effectively controlled by a self-designed stereotaxic device in humeral head replacement .The pre-operative average humeral length was (28.57 ±2.38) cm (range, 26.01-32.58 cm), and the average humeral head retroversion angle was (23.0°±5.8°) (range, 11.1°-28.7°), respectively.There was no significant difference between the pre-and post-operative humeral length or the humeral head retroversion angle.Conclusion The application of the self-designed stereotaxic device according to the contra-lateral data measured by the digital technology could lead to a more personalized and accurate humeral head replacement .