CAJ | 학술논문

目的探讨胫骨平台骨折Schatzker分类三维数字化模型的建立及其在虚拟手术中的应用.方法对健康男性志愿者行股骨下段及胫骨中上段64排螺旋CT扫描,所得数据应用Mimics10.01软件处理,重建出胫骨近端模型,依照胫骨平台骨折Schatzker分类的标准模拟出各型骨折.对骨折模型进行截图保存,并输出影片模式.胫骨平台骨折Schatzker分类骨折模型导入FreeForm Modeling System中,运用力反馈设备,进行虚拟骨折手术模拟.利用FreeForm Modeling System的GHOST开发出虚拟切割和骨折复位固定的软件,然后利用力反馈设备PHANTOM,对手术器械和骨折块进行操纵,模拟器械组装、钻孔、螺钉拧入、骨折复位、植骨等动作,完成骨折复位、内固定等手术操作.结果胫骨平台骨折Schatzker分类三维数字化模型直观、立体、逼真,具有很好的视觉效果,可以从任意的方位和角度观察和截图,相对应的动画可以360°旋转观看.在FreeForm Modeling System 中,建立的虚拟手术环境具有很强的真实感、沉浸感和临场感,并有交互性和力反馈功能.使用者可以根据Schatzker分类每型骨折的特点决定手术方案、选择内固定物,在虚拟系统中进行反复的操作练习.结论胫骨平台骨折Sehatzker分类的三维数字化模型具有直观、立体、逼真、动态等特点.使用胫骨平台骨折Schatzker分类虚拟手术系统可以使手术培训更加规范化、程序化和标准化,也可以作为临床手术前的规划和医患沟通的工具.
목적 탐토경골평태골절Schatzker분류삼유수자화모형적건립급기재허의수술중적응용.방법 대건강남성지원자행고골하단급경골중상단64배라선CT소묘,소득수거응용Mimics10.01연건처리,중건출경골근단모형,의조경골평태골절Schatzker분류적표준모의출각형골절.대골절모형진행절도보존,병수출영편모식.경골평태골절Schatzker분류골절모형도입FreeForm Modeling System중,운용력반궤설비,진행허의골절수술모의.이용FreeForm Modeling System적GHOST개발출허의절할화골절복위고정적연건,연후이용력반궤설비PHANTOM,대수술기계화골절괴진행조종,모의기계조장、찬공、라정녕입、골절복위、식골등동작,완성골절복위、내고정등수술조작.결과 경골평태골절Schatzker분류삼유수자화모형직관、입체、핍진,구유흔호적시각효과,가이종임의적방위화각도관찰화절도,상대응적동화가이360°선전관간.재FreeForm Modeling System 중,건립적허의수술배경구유흔강적진실감、침침감화림장감,병유교호성화력반궤공능.사용자가이근거Schatzker분류매형골절적특점결정수술방안、선택내고정물,재허의계통중진행반복적조작연습.결론 경골평태골절Sehatzker분류적삼유수자화모형구유직관、입체、핍진、동태등특점.사용경골평태골절Schatzker분류허의수술계통가이사수술배훈경가규범화、정서화화표준화,야가이작위림상수술전적규화화의환구통적공구.
Objective To explore the establishment of Schatzker classification digital model of tibial plateau fractures and its application in virtual surgery.Methods Proximal tibial of one healthy male volunteer was examined with 64-slice spiral computed tomography (CT).The data were processed by software Mimics 10.01 and a model of proximal tibia was reconstructed.According to the Schatzker classification criteria of tibial plateau fractures,each type of fracture model was simulated.Screen-captures of fracture model were saved from different directions.Each type of fracture model was exported as video mode.Fracture model was imported into FreeForm modeling system.With a force feedback device,a surgeon could conduct virtual fracture operation simulation.Utilizing the GHOST of FreeForm modeling system,the software of virtual cutting,fracture reduction and fixation was developed.With a force feedback device PHANTOM,a surgeon could manipulate virtual surgical instruments and fracture classification model and simulate surgical actions such as assembly of surgical instruments,drilling,implantation of screw,reduction of fracture,bone grafting and fracture fixation,etc.Results The digital fracture model was intuitive,three-dimensional and realistic and it had excellent visual effect.Fracture could be observed and charted from optional direction and angle.Fracture model could rotate 360 ° in the corresponding video mode.The virtual surgical environment had a strong sense of reality,immersion and telepresence as well as good interaction and force feedback function in the FreeForm modeling system.The user could make the corresponding decisions about surgical method and choice of internal fixation according to the specific type of tibial plateau fracture as well as repeated operational practice in virtual surgery system.Conclusion The digital fracture model of Schatzker classification is intuitive,three-dimensional,realistic and dynamic.The virtual surgery systems of Schatzker classifications make the virtual surgery training more normalized,programmed and standardized.In addition,virtual surgery system can serve as a new tool for preoperative planning and surgeon-patient interactions.