计算机辅助设计个体化经皮空心螺钉内固定治疗腕舟骨骨折的应用

Application of individualization percutaneous cannulated screws fixation with the help of computer-assisted design in carpal scaphoid fracture

目的利用Mimics软件设计一种腕舟骨骨折个体化掌侧经皮空心螺钉置钉技术。方法将24例成人腕舟骨骨折腕关节CT扫描数据导入Mimics软件,在Mimics软件中进行腕关节三维重建,模拟舟骨手术,制定舟骨个体化置钉参数并模拟置钉,据此参数在腕舟骨上经皮置钉。术后行腕关节CT扫描,验证置钉准确性。结果 Mimics重建图像和CT扫描的腕舟骨参数差异无统计学意义,能准确反映舟骨三维立体结构。用该方法对24例成人腕舟骨骨折行经皮空心螺钉固定,术后CT显示螺钉位置良好,随访腕关节功能良好。结论用Mimics软件对腕关节进行三维重建,模拟手术,测量、制订详细合理的个体化置钉参数,可优化手术方案与方式,减少并发症,降低手术风险,提高临床治疗效果。

Objective To provide a individualization volar percutaneous cannulated screws fixation with the help of Mimics-assisted design in carpal scaphoid fracture surgery. Methods Three-dimensional reconstruction of 24 CT scanned adult carpal scaphoid fractures were performed by using Mimics software. The operations were analogued in Mimics software and then individual fixation parameters were designed. Based on which percutaneous cannulated screws fixation of carpal scaphoid fracture were performed under Mimics individual fixation parameters. The accuracy of postoperation was assessed by CT scanning. Results There was no statistical difference in parameters of the CT scan and Mimics reconstruction images, which could reflect carpal scaphoid accurate three dimensional structure. Postoperation CT scanning showed that the cannulated screws were fixed successfully in 24 adult carpal scaphoid frac-tures. The function of wrists were well in follow-up. Conclusions Three-dimensional reconstruction of the carpal scaphoid by using mimics software, sham operated,measurement and design individual screw fixation parameters, can optimize operation schedule and method,decrease operation complication and risk, improve treatment effectiveness of clinical.