计算机辅助导航系统在复杂眶周骨折中的应用

Application of a computer-assisted navigation system （CANS） in the treatment of complicated orbital fractures

目的评价计算机辅助导航系统在复杂眶周骨折切开复位内固定术中的作用。方法6例复杂眶周骨折患者术前行CT扫描，将数据导人外科规划软件，3D重建及分割骨块后，利用健侧数据镜像后位置指导移位骨块复位，进行虚拟外科手术。在导航系统引导下，患者行骨折复位术，骨折块移动到预先设计的位置。术后CT测量评价导航精度及骨的对称性。结果通过导航系统将CT影像与术中解剖结构相匹配，误差在1mm以内。所有患者在导航引导下行骨折切开复位内固定术，术后CT扫描，与术前计划比较，图像基本一致，健侧与患侧颧骨突度及宽度比较，差值小于2mm，术后患者外形明显改善。结论对于复杂眶周骨折，导航引导下的切开复位内固定术能够提高手术效果。

Objective To evaluate the effectiveness of computer-assisted navigation system on open reduction as treatment for complicated orbital fractures. Methods The computed tomography （CT） data for 6 patients with complicated orbital fractures were obtained before surgery and imported into the surgical planning software. After 3-dimensional （dD） construction and segmentation, data from the unaffected side were used to guide the reduction data, and surgical simulation was performed. All patients underwent open reduction under the guidance of the navigation system. The segments were then reduced to the predetermined places. CT measurements were used to evaluate navigation ac- curacy and bone symmetry. Results A fairly accurate match between the intraoperative anatomy and the eomputed tomography images was achieved through registration, with a systematic error of 1 mm difference. With guidance of the navigation system, open reduction of fractures was performed in all cases. The reduction was checked by postoperative computed tomography scans, with a good match with preoperative planning noted. The maximal deviation between the reduction and preoperative plan- ning was less than 2 mm. The postoperative facial appearance of the patients was clearly improved. Conclusions Navigation-guided open reduction of complicated orbital fractures can be regarded as a valuable treatment option for this potentially complicated procedure.