髋臼骨缺损结构性植骨的术前数字化设计

Preoperative digital design of structural bone graft for acetabular wall defects

目的探讨髋臼骨缺损结构性植骨术前数字化设计的临床应用价值。方法选择一例左侧髋臼缺损老年女性患者，经16排螺旋CT断层扫描获得的髋臼骨缺损患者的骨盆原始．dicom数据输入Mimics10．0软件重建骨盆三维实体模型，经镜像、3D蒙罩编辑等处理，获得结构性植骨骨块的三维实体模型。选择同种异体跟骨，根据三维模型所测量数据切割和修琢植骨块，行缺损区植骨。结果重建的骨盆三维模型逼真，可以多彩、透明和多种组合显示，可以从不同的角度观察骨缺损部位。结构性植骨块三维立体形态可以逼真显示，并可获得植骨块的各种几何数据。术中植骨块与缺损区吻合好，临床应用效果良好。结论髋臼骨缺损结构性植骨术前可简便、快捷地建立所需植骨块的数字化模型，且所建模型形态逼真，可以增加植骨块与缺损区的匹配度，提高一次手术的成功率，具有良好的临床应用前景。

Objective To discuss the value of preoperative digital design of structural bone graft for acetabular wall defects. Methods The . dicom data from spiral CT scans were imported into Mimics 10.0 to build the 3D solid model of the pelvis of an old female patient with left acetabular wall defects. The 3D solid model of the defect area was built by Mirror and 3D mask editing. A simulated bone graft was conducted on the 3D model by segmentation and trimming according to the data measured on the reconstructed model. Results The reconstructed 3D model of the patient＇s pelvis could be presented in different colors, transparences, or combinations of interested tissues. The acetabular wall defects could be visualized very clearly at different angles. The geometric data of the bone graft could be measured to ensure the bone graft would fit the defects accurately. Conclusion Preoperative digital design based on 3D computerized reconstruction of aeetabular wall defects may provide a valuable aid to clinical treatment, because it is a simple, rapid, and accurate method of increasing the fitness of bone graft and the defects.