距骨骨折线的三维形态学分析

Study on Three-Dimensional Morphological Analysis of the Talus Fracture Lines

目的:距骨由于其特殊的解剖结构与血供系统,骨折可累及多个关节面,骨折形态复杂,损伤后并发症高发,因此术前对骨折形态的三维可视化显得非常重要。通过以CT原始数据为基础,重建骨折三维形态为背景,分析距骨骨折线的位置、频率,以期指导临床治疗。方法:回顾性研究与分析46例距骨骨折患者。在MIMICS 10.1软件中分离并重建距骨骨折块,与标准距骨空间配准、虚拟复位,将各个距骨骨折模型的骨折线在Geomagic Studio 12软件中临摹,并将全部骨折线投影至标准距骨表面。结果:距骨头、距骨颈、距骨体的骨折线分别占4.2%、37.5%和58.3%。骨折线在距骨颈处密集呈横向走行,在距骨体散在分布、走行无明显规律。结论:约37.5%骨折线多集中于距骨颈处,其走行多与距骨体纵轴接近垂直,距骨颈骨折可由前往后或由后往前纵向置钉。约58.3%骨折线散在分布于距骨体处,距骨体骨折线走行方向无规律,需按照个体化骨折形态选择内固定方案。

Objective: It is because of talus special anatomical structure and blood supply system, the fractures may involve multiple articular surfaces. There are high incidence of complications after injury. The aim of this study was to reconstruct the threedimensional shape of fracture based on the original CT data and analyze the position and frequency of the talus fracture lines to guide the clinical treatment. Methods: 46 talus fractures were retrospectively reviewed. Separating and reconstructing talus fracture and then registering with standard template in Mimics 10.1. Delineating every fracture lines of talus model in the Geomagic Studio 12, and then projecting all of fracture lines to the surface of standard template. Results: We observed the characteristics of fracture lines on a threedimensional model that the fracture lines accounted for the head of talus, talus neck, talus body about 4.2%, 37.5% and 58.3%,and the fracture lines ran horizontally across the talus neck and was scattered within the body.