本文關(guān)鍵詞： 順行肱骨髓內(nèi)釘 數(shù)字化設(shè)計(jì) 3D打印技術(shù) 進(jìn)釘點(diǎn)　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:1、初步學(xué)習(xí)與掌握醫(yī)學(xué)數(shù)字化設(shè)計(jì)結(jié)合3D打印技術(shù);2、探索研究3D打印導(dǎo)板在輔助順行肱骨髓內(nèi)釘置釘過程中的臨床價(jià)值。方法:本研究收集了本院2016年1月至2017年1月于接受上肢CTA檢查的13例患者的薄層CT掃描數(shù)據(jù),并將其導(dǎo)入Mimics17.0軟件中,進(jìn)行三維重建及相應(yīng)處理獲得肱骨及肩關(guān)節(jié)骨性三維模型;應(yīng)用擬合中心線等工具在肱骨近端確定其理想進(jìn)釘點(diǎn);把重建的模型導(dǎo)入Magic20軟件中,分別以兩套定位點(diǎn)方案設(shè)計(jì)導(dǎo)板:方案一以肱骨大小結(jié)節(jié)為定位點(diǎn),方案二則以鎖骨遠(yuǎn)端,肩峰及喙突為定位點(diǎn);將設(shè)計(jì)好的導(dǎo)板及重建的肩關(guān)節(jié)運(yùn)用3D打印技術(shù)制作出實(shí)體模型,并模擬導(dǎo)板輔助髓內(nèi)釘導(dǎo)針穿刺;最后采用X線透視驗(yàn)證其穿刺效果。結(jié)果:13個(gè)病例均應(yīng)用上述兩個(gè)方案設(shè)計(jì)并打印導(dǎo)板,模擬穿刺均能順利穿入髓腔。經(jīng)過X線透視,髓釘導(dǎo)針也基本上都在髓腔的中心,并通過狹窄處中心。結(jié)論:數(shù)字化設(shè)計(jì)結(jié)合3D打印技術(shù)制作的導(dǎo)板能夠輔助順行肱骨髓內(nèi)釘準(zhǔn)確置釘,改變了傳統(tǒng)憑借經(jīng)驗(yàn)置釘模式,可避免反復(fù)盲穿。但需要進(jìn)一步臨床驗(yàn)證并改進(jìn)。
[Abstract]:Objective: to explore the clinical value of 3D printing guide plate in the process of assisted anterograde humeral intramedullary nail placement. Methods: the clinical value of 3D printing guide plate in the process of assisted anterograde humeral intramedullary nail placement was investigated. Up to January 2017, thin slice CT scan data of 13 patients undergoing upper limb CTA examination, The 3D model of humerus and shoulder bone is obtained by three dimensional reconstruction and corresponding processing, and the ideal point of nail is determined in the proximal humerus by means of fitting centerline, and the reconstructed model is imported into Magic20 software. Two sets of location-point schemes were used to design the guide plate: one was based on the humeral nodule and the other was based on the distal clavicle, acromium and coracoid process. The designed guide plate and the reconstructed shoulder joint were used to make the solid model by 3D printing technology, and the guide plate was simulated to assist the puncture of the intramedullary nail guide needle. Finally, X-ray fluoroscopy was used to verify the puncture effect. Results: all the 13 cases were designed and printed the guide plate with the two schemes mentioned above, and simulated puncture could enter the medullary cavity smoothly. After X-ray fluoroscopy, the needle was basically in the center of the medullary cavity. Conclusion: the guide plate made by digital design combined with 3D printing technology can assist in accurate nail placement of the anterograde humeral intramedullary nail, which changes the traditional experience nailing mode. Repeated blind puncture can be avoided, but further clinical validation and improvement are needed.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

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