数字化重建与快速成型技术在儿童高弓足的临床应用

Clinical Application of Digital Reconstruction and Rapid Prototyping Technology in Children with Talipes Cavus

目的:探讨并评价数字化重建与快速成型技术在儿童高弓足的临床疗效。方法:回顾性分析了2013年4月至2017年4月对收治的14例(21足)儿童高弓足患儿的病例资料,利用整个足部CT平扫数据进行计算机三维建模、依靠数字化重建与快速成型技术制作出与实体1:1等比例大小的高弓足模型,根据患者的畸形情况,对模型进行术前制定手术方案,手术规划和模拟手术,并指导高弓足截骨矫正手术治疗。结果:14例患儿均获得12~36个月,平均17.6个月。所有患儿术后切口均一期愈合,无1例出现伤口感染。在手术过程中所见到的畸形情况与数字化三维重建图像及计算机辅助快速成型高弓足模型一致,术前的模拟手术减少了手术的操作时间,达到更佳的手术效果。结论:数字化重建与快速成型技术能够准确和直观地反映儿童高弓足的立体形态和畸形部位的解剖结构关系,而且在儿童高弓足截骨手术中能够进行术前设计和模拟,有助于精确矫正畸形,提高患儿的满意度和预后,疗效确切。

Objective: To investigate the clinical efficacy of digital reconstruction and rapid prototyping in the treatment of talipes cavus in children. Methods: The clinical data of 21 feet from 14 patients with equinovarus talipes cavus were retrospective analyzed in our hospital from April 2013 to April 2017. All of them were examined by lamellar CT to gain two-dimensional data of diseased region. Three-dimensional reconstructions of anatomical models were accomplished by computer aided technology. By rapid prototyping, the feet models were manufactured, operation project were formulated, preoperative sham operated were enforced and supervise the operation of osteotomy surgery of deformed feet in children. Results: All patients were followed up for 12~36 months, with an average of 17.6 months. All the incisions healed at the same time without any incision infection. The deformities seen in the operation process are consistent with the digital three-dimensional reconstruction image and the computer-aided rapid prototyping high arch foot model. The simulation operation before the operation reduces the operation time and achieves better operation effect. Conclusion: 3D printing technology can reveal overall, direct-viewing, exactly display three-dimensional shape of complicated deformities, which can make operation excellent safer and more convenient. It can realize preoperative design and operation preview, correct the deformity, increase patient satisfaction and curative effect.