计算机辅助快速成型技术在复杂骨盆骨折诊断与治疗中的应用

The application of computer aided rapid prototyping technology in diagnosis and treatment of complicated pelvic fractures

目的：评价计算机辅助快速成型技术在复杂骨盆骨折诊断与治疗中的应用价值。方法：对22例复杂骨盆骨折患者行薄层CT扫描获取骨盆二维数据．采用计算机辅助技术重建三维模型，快速成型技术制出与实体1：1大小的骨盆模型。依此对骨盆骨折做出明确的诊断、分型，制定手术方案．模拟手术，指导手术治疗。结果：所有患者术中所见与三维重建图像及快速成型模型非常相似，术前的模拟缩短了手术时间，减少了出血量。随访6～24个月，术后2～4周患者可在床上坐起，6周后可扶拐下地活动。所有患者均获得了良好的骨折复位。根据Majeed功能评分标准，优：16例，良：3例，优良率86．4％。结论：计算机辅助快速成型技术能直观、精确地显示骨盆的立体形态和各解剖结构的空间关系，对骨盆骨折的诊断、分型及治疗有很好的临床指导作用。

Objective To evaluate the value of computer aided rapid prototyping technology in diagnosis and treatment of complicated pelvic fractures. Methods Twenty-two patients of complicated pelvic fractures were examined by thin-slice CT to gain two-dimensional data of the pelvis. Three-dimensional reconstructions of anatomical models were accomplished by computer aided technology. By rapid prototyping technology, the pelvic models were rendered, by which diagnosis and typing of pelvic fractures were finalized for operation project, mimic operation and guiding the operation. Results Three-dimensional reconstruction images and rapid prototyping pelvic models were extremely similar to what doctors saw in the operations. Preoperative mimic operation shortened the time of operation and reduced the volume of bleeding in the operation. All 22 cases were available for review in follow-up period of 6 - 24 months. Patients could sit up in 2 - 4 weeks after surgery, and walk with a crutch 6 weeks later. Pelvic fractures reductions were good in 22 cases. According to the Majeed＇s functional criteria, 16 patients were judged excellent and 3 patients were good. The excellent and good rate was 86.4%. Conclusions Computer aided rapid prototyping technology can overall, direct-viewing, and exactly display the three-dimensional shape of pelvis and spatial relation of anatomic structures. It is important for definite clinic diagnosis, typing and treatment.