计算机-快速成型辅助模拟空心螺钉治疗股骨颈骨折

Computer-rapid molding-assisted simulation of hollow screw for femoral neck fracture

目的通过计算机-快速成型辅助模拟空心螺钉治疗股骨颈骨折在新鲜尸骨中的应用,验证计算机-快速成型辅助模拟空心螺钉治疗股骨颈骨折的可靠性及准确性。方法在股骨头外上象限用玻璃离子标记为空心螺钉固定股骨颈骨折目标靶点,在大转子顶端及下方打入3枚定位克氏针。对处理好的标本行CT扫描。将扫描数据导入Mimics软件,三维重建股骨上端并显示空心螺钉固定股骨颈骨折目标靶点,设计空心螺钉在股骨颈中的位置通道。在Pro/E软件中,绘制与股骨上端的3枚定位克氏针及空心螺钉引导针适配的导向器,利用快速成型技术制成导向器。将导航模板安装至定位针上通过空心螺钉引导孔,钻入空心螺钉引导针,为治疗股骨颈骨折打入空心螺钉完成定位以及导向。根据空心螺钉引导针与目标靶点中心的在Mimics软件三维重建坐标系中的坐标,应用空间距离计算公式计算出空心螺钉引导针与目标靶点中心距离。结果对空心螺钉引导针进针终点与目标靶点坐标分析可计算得出,固定股骨颈骨折空心螺钉引导针的进针终点与目标靶中心点平均距离为1.92 mm。结论计算机-快速成型辅助空心螺钉固定股骨颈骨折可靠精准,为实现临床个体化、精准化空心螺钉固定股骨颈骨折提供了一种新思路和方法。

Objective The application of computer-rapid prototyping-assisted simulated hollow screw in the treatment of femoral neck fractures in fresh cadavers verified the reliability and accuracy of computer-rapid prototyping-assisted simulated hollow screw in the treatment of femoral neck fractures.Methods The glass ion was labeled as a target for the treatment of femoral neck fracture with a cannulated screw.Three Kirschner pins were placed at the top and bottom of the greater trochanter.CT scan of the processed specimens.The scan data was imported into Mimics software,and the upper end of the femur was reconstructed three-dimensionally and the target of the femoral neck fracture was fixed with cannulated screws.The position of the cannulated screw in the femoral neck was designed.In Pro/E software,draw a guide that fits the three positioning Kirschner pins and cannulated screw guide needles on the upper end of the femur,and use rapid prototyping technology to make the guide.The navigation template was mounted on the positioning pin through the cannulated screw guiding hole,and the hollow screw guiding needle was drilled,and the hollow screw was inserted for the treatment of the femoral neck fracture to complete the positioning and guiding.According to the coordinates of the hollow screw guide needle and the target center in the Mimics software three-dimensional reconstruction coordinate system,the spatial distance calculation formula is used to calculate the distance between the hollow screw guide needle and the target center.Results The coordinate analysis of the end point of the cannulated screw guide needle and the target can be obtained that the average distance between the end point of the cannulated screw guide needle for fixed femoral neck fracture and the target center point was 1.92 mm.Conclusion The computer-rapid molding-assisted cannulated screw fixation of the femoral neck fracture is reliable and accurate,which provides a new idea and method for clinical individualization and precise fixation of the femoral neck fracture.