应用Mimics软件构建钩骨3D可视化解剖学研究

Application of Mimics software to construct 3D visual anatomy of hamate bone

目的利用Mimics软件3D可视化分析钩骨形态及其骨内血管走行,为钩骨骨折治疗及其相关手术提供解剖学基础。方法选用成人新鲜上肢标本12例,灌注后行Micro-CT扫描,将所得数据导入Mimics软件重建钩骨及其血供。结果钩骨有3个非关节面。背侧和掌侧表面呈三角形,掌侧面尺侧向掌侧延伸形成钩骨钩。钩骨钩分为顶部,中部及基底部。钩骨远端关节面与第4、5掌骨基底部形成腕掌关节,桡侧与头状骨形成关节,尺侧与三角骨形成关节。在背侧非关节面由微小动脉网分支成数根滋养血管进入钩骨体内,并在各方向分支营养钩骨体。在掌侧非关节面钩骨体钩骨钩移行处,即钩骨钩基底部桡侧1-2根滋养血管直接或分支进入骨内,并分别向钩骨体及钩骨钩内走行。部分标本钩骨钩基底部尺侧出现滋养血管由此进入骨内并向钩骨钩内分支走行。钩骨钩顶端有单独的小血管进入并在骨内分支。钩骨钩基底部桡侧滋养血管骨内分支分别与由钩骨体背侧及钩骨钩顶端滋养血管骨内分支相互吻合。结论钩骨体和钩骨钩内血供丰富,较难发生缺血性坏死。钩骨钩骨折保守治疗不愈合可能是由骨折类型及移位程度较大导致。

Objective To analyze the morphology of the hook bone and its intravascular bone shape by using the mimics software 3 D visualization, which provided an anatomical basis for the treatment of hook fracture and its related surgery. Methods Twelve cases of fresh upper limb specimens were selected. After perfusion, Micro-CT scan was performed. The data were imported into Mimics software to reconstruct the hooked bone and its blood supply. Results The hooked bone had 3 non-articular surfaces. The dorsal and volar surfaces were triangular, and the lateral side of the palm extended laterally to the volar side to form a hooked bone hook. The hooked bone hook was divided into a top side, a middle side and a base side. The distal joint surface of the hooked bone and the base of the 4 th and 5 th metacarpal bones formed the carpometacarpal joint, the radial side and the head bone formed a joint, and the ulnar side and the triangular bone formed a joint. The non-articular surface on the dorsal side was branched into a number of nourishing blood vessels into the bone of the hook bone by the micro-arterial network, and the hooked bone blood supply supplied in all directions. In the volar side of the non-articular surface hooked bone, which was, the 1-2 root nourishing blood vessels of the basal part of the hooked bone hook branched into the bone directly, and travelled to the hooked bone body and the hooked bone hook respectively. Part of the specimen had a nourishing blood vessel on the ulnar side of the base of the hooked bone, thereby entering the bone and branching into the hooked bone. There were separate small blood vessels at the tip of the hooked bone that entering and branching within the bone. The iliac bone branch of the humerus at the base of the hooked bone was consistent with the intravascular branch of the trophoblastic nucleus from the dorsal side of the hook bone and the hook of the hook. Conclusions The blood supply in the hook bone is rich, and ischemic necrosis is difficult to occur. The conservative treatment of nonunion of hook-and-loop fractures may be caused by the type of fracture and the degree of displacement.