基于多平面三维测量的髋臼骨折数字化内固定植入方案

A digital solution for fixation implant of acetabulum fracture based on multi-planes three-dimensional measurements

目的探讨髋臼骨折数字化内固定植入方案的实施方法及相应规范。方法绘制重建钢板及螺钉Solidworks零件文件,制备标准件库。将1具成人尸体骨盆标本进行薄层CT扫描及三维重建,以三维切割的方式按照AO分类进行髋臼骨折9个类型造模,虚拟复位后预设重建钢板的植入位置,进行长度及角度的三维测量,根据测量数据在Solidworks中预弯重建钢板并输出至Mimics,通过位移的方式将重建钢板植入至预设位置,测量钉孔至对侧骨面的距离,选择合适的螺钉,完成虚拟髋臼骨折内固定植入。结果 (1)完成髋臼骨折9个类型造模;(2)完成髋臼骨折9个类型的虚拟重建钢板及螺钉的内固定植入,全部重建钢板与骨面敷贴良好,所有螺钉均植入至对侧骨面。结论多平面三维测量是实施髋臼骨折数字化内固定植入方案的决定因素。

Objective To investigate a digital solution and the corresponding standards for fixation implant of acetabulum fracture. Methods Solidworks files of reconstruction plates and screws were drawn for the preparation of standard parts library. One pelvic specimens of adult corpse was treated with thin-slice CT scan and three- dimensional reconstruction. Nine kinds of acetabulum fracture models were harvested by three-dimensional cutting according to the AO classifications. After virtual reduction, the implanted position of reconstruction plate was presupposed to measure the three-dimensional length and angle. The prebending of reconstruction plate was performed in Solidworks and exported to Mimics, then was implanted to the presupposed position by means of reposition. The distance from countersunks of reconstruction plate to contralateral osseous surface were measured to selected suitable screws for virtual fixation implant of acetabulum fracture. Results （ 1 ） Nine kinds of acetabulum fracture models were made successful; （2） Virtual fixation implants of reconstruction plates and screws on nine kinds of acetabulum fracture were accomplished successfully. Sticking effects of reconstruction plates to osseous surface were shown very good, and the screws were implanted to the contralateral osseous surface accurately. Conclusions Multi-planes three-dimensional measurement is the determinative factor for digital solution of fixation implant of acetabulum fracture.