跟骨骨折内骨缺损的三维重建与参数测量

Three⁃dimensional Reconstruction and Parameter Measurement of Bone Defect in Calcaneal Fracture

目的应用跟骨骨折CT影像资料建立跟骨内部骨缺损的数字化模型,并进行相关参数的测量,为术中是否需要植骨提供参考。方法回顾性分析2013年至2019年于我院进行检查的62例(66足)跟骨骨折病人的CT影像资料,其中男54例,女8例,年龄为(49.0±12.7)岁(27~79岁)。应用Mimics软件进行三维重建、虚拟复位,还原跟骨外形,分离内部骨缺损,测量骨缺损的形态学参数,进而分析不同Sanders分型间骨缺损的差异。结果本组病人跟骨骨折复位后,内部骨缺损体积为(2419.69±1371.26)mm~3,高度为(17.52±7.53)mm,宽度为(18.56±6.12)mm,长度为(22.33±8.91)mm。左右侧比较,各测量参数之间的差异均无统计学意义(P均>0.05)。不同Sanders分型间骨缺损测量值差异较大,Ⅲ型骨折和Ⅳ型骨折的体积、高度、宽度、长度均大于Ⅱ型骨折(P均<0.05);而Ⅲ型骨折和Ⅳ型骨折之间,各测量参数的差异均无统计学意义(P均>0.05)。不同Sanders分型亚型间骨缺损差异不大,ⅡA型与ⅡB型仅在长度方面存在差异(P<0.05),Ⅲ型各亚型间骨缺损基本接近。结论跟骨骨折复位后的骨缺损在不同Sanders分型间存在差异,而在各亚型之间,骨缺损大小接近,可以为术中是否需要植骨提供参考。

Objective To establish digital models of calcaneal bone defect based on CT images and to measure the relevant parameters,as the basis for bone grafting during the operation.Methods A retrospective study in our hospital from 2013 to 2019 was carried out.CT data of calcaneal fracture of 62 patients(66 feet)were gathered,including 54 males and 8 females with the age of(49.0±12.7)years old(27⁃79 years old).Mimics software was used to reconstruct and restore the appearance of calcaneus,separate the bone defects and measure the parameters.The size and shape of bone defects between different Sanders types were analyzed.Results The volume was(2419.69±1371.26)mm3,the height was(17.52±7.53)mm,the width was(18.56±6.12)mm,the length was(22.33±8.91)mm and there was no significant difference between left and right sides.The parameters of Sanders typeⅢandⅣcalcaneus fractures were significantly larger than those of Sanders typeⅡ(P<0.05),but there was no significant difference between the parameters of Sanders typeⅢandⅣ(P>0.05).There was no significant difference in bone defects among different Sanders subtypes,but there was only difference in length between typeⅡA and typeⅡB(P<0.05).Conclusion The size of the bone defects of calcaneal fracture is different among different Sanders types.However,the size of bone defect is close among the subtypes,which can provide a reference for whether bone graft is needed in the operation.