胫骨近端骨折数字化内固定的临床研究

Clinical research on digital internal fixation for proximal tibial fracture

目的探讨医用软件Mimics、Solidworks在胫骨近端骨折中三维重建、复位的效果,并设计内固定方案。方法 30例胫骨近端骨折患者(数字化组),进行高速CT薄层扫描,在Mimics中对骨折进行重建、复位,以Solidworks进行内固定钢板、螺钉的选择和设计,并在骨折复位三维模型上进行虚拟内固定。临床据此方案进行手术,观察治疗效果,与按传统经验的30例患者(对照组)进行对比。结果数字化组所有骨折均进行了三维重建、复位,以准确的内固定钢板及螺钉进行了虚拟内固定。临床手术顺利,按术前设计的数字化方案成功完成,疗效满意。在术中出血量、手术时间、术后引流量、住院时间、骨折愈合时间等方面优于对照组。结论应用Mimics及Solidworks可在个人电脑上设计出胫骨近端骨折内固定手术的数字化方案。

Objective To explore the effect of Mimics,Solidworks（medical software） in performing three-dimensional reconstruction and reduction on proximal tibial fracture,and to design digital internal fixation plan. Methods Thirty patients with proximal tibial fracture（digital group）were treated with CT scan. Three-dimensional reconstruction and reduction were performed in Mimics. The plates and screws were designed and selected in Solidworks. Virtual internal fixation on the reduction three-dimensional models was performed. The clinical operation was performed on the basis of the scheme,and the curative effect was observed and compared with 30 cases patients treated by the traditional operation（control group）. Results All the fractures were performed with three-dimensional reconstruction and reduction in the digital group,and the accurate design for internal fixation plates and screws as well as virtual internal fixation were accomplished. The clinical operations finished successfully according to the digital scheme of the preoperative design. The curative effect was satisfactory. Indexes such as bleeding volume,operation time,postoperative drainage,hospital stay and healing time of fracture in the digital group were better than those in the control group. Conclusion The digital scheme for internal fixation of proximal tibial fracture can be designed in Mimics and Solidworks with a personal computer.