【摘要】：目的探討Mimics18.0軟件數(shù)字化設(shè)計(jì)結(jié)合3D打印骨折模型進(jìn)行手術(shù)規(guī)劃,術(shù)前模擬手術(shù),輔助治療復(fù)雜型股骨髁上骨折內(nèi)固定及在醫(yī)患溝通環(huán)節(jié)的效果研究。方法篩選10例復(fù)雜型股骨髁上骨折患者,將患者的骨折部分及全套內(nèi)固定物的薄層CT數(shù)據(jù)導(dǎo)入Mimics 18.0軟件,進(jìn)行骨折三維建模、骨折塊虛擬復(fù)位、建立股骨髁上骨折內(nèi)固定物標(biāo)準(zhǔn)件庫、選取最佳匹配的鋼板及螺釘。3D打印出患者1:1的股骨髁上骨折實(shí)體模型,術(shù)前應(yīng)用3D打印模型與患者及其家屬溝通并進(jìn)行3D打印模型的效度驗(yàn)證。讓患者及其家屬直接接觸骨折3D模型并觀看在模型上按照數(shù)字化設(shè)計(jì)進(jìn)行模擬手術(shù)—將股骨髁上重建板的位置、釘?shù)篱L度和方向同數(shù)字化設(shè)計(jì)比較,確定術(shù)中使用的鋼板及螺釘。最后,按照術(shù)前模擬演練進(jìn)行實(shí)際手術(shù)骨折復(fù)位、鋼板內(nèi)固定。結(jié)果術(shù)前應(yīng)用3D模型獲得了良好的溝通效果,患者及其家屬理解度和滿意度高。應(yīng)用3D打印技術(shù)模擬手術(shù)共植入1塊鎖定鋼板和8枚螺釘,鋼板植入的位置、螺釘植入的方向均與數(shù)字化術(shù)前設(shè)計(jì)高度一致,釘?shù)篱L度與數(shù)字化術(shù)前設(shè)計(jì)比較無顯著性差異(P0.05)。實(shí)際手術(shù)與模擬手術(shù)的手術(shù)效果一致。結(jié)論數(shù)字化設(shè)計(jì)結(jié)合3D打印技術(shù)在醫(yī)患溝通方面效果顯著,且實(shí)現(xiàn)了復(fù)雜型股骨髁上骨折的個(gè)體化、精準(zhǔn)化治療,明顯減少了患者的術(shù)中出血量,縮短了患者的康復(fù)周期。
[Abstract]:Objective to investigate the effect of digital design of Mimics18.0 software combined with 3D printing fracture model for surgical planning, preoperative simulation surgery, auxiliary treatment of complex supracondylar fracture of femur and communication between doctors and patients. Methods Ten patients with complex supracondylar fracture of femur were selected. The thin layer CT data of fracture part and complete set of internal fixation were imported into Mimics 18.0 software to carry out 3D modeling of fracture, virtual reduction of fracture block, establishment of standard parts library of internal fixation of supracondylar fracture of femur, selection of best matching plate and screw. 3D printing out the solid model of supracondylar fracture of femur at 1:1. The 3D printing model was used to communicate with the patients and their families before operation, and the validity of the 3D printing model was verified. The patients and their families were asked to contact the 3D model of fracture directly and watch the simulated operation according to the digital design on the model. The position, length and direction of the supracondylar reconstruction plate were compared with the digital design, and the plate and screw used during the operation were determined. Finally, according to the preoperative simulation exercise, the actual surgical fracture reduction and plate internal fixation were carried out. Results the 3D model was used before operation to obtain good communication effect, and the understanding and satisfaction of the patients and their families were high. 3D printing technique was used to simulate the implantation of 1 locking plate and 8 screws. The position of plate implantation and the direction of screw implantation were highly consistent with those of digital preoperative design. There was no significant difference in nail channel length between digital preoperative design and digital preoperative design (P 0.05). The effect of actual operation is consistent with that of simulated operation. Conclusion Digital design combined with 3D printing technology is effective in doctor-patient communication, and realizes the individualized and accurate treatment of complex supracondylar fracture of femur, which can significantly reduce the amount of intraoperative blood loss and shorten the rehabilitation cycle of patients.
【作者單位】： 中山市古鎮(zhèn)人民醫(yī)院骨科廣東省創(chuàng)傷救治科研中心古鎮(zhèn)基地南方醫(yī)科大學(xué)數(shù)字醫(yī)學(xué)研究所3D打印中心古鎮(zhèn)基地;中山市古鎮(zhèn)人民醫(yī)院泌尿外科;南方醫(yī)科大學(xué)基礎(chǔ)醫(yī)學(xué)院人體解剖學(xué)教研室廣東省醫(yī)學(xué)生物力學(xué)重點(diǎn)實(shí)驗(yàn)室;
【基金】：廣東省科技計(jì)劃項(xiàng)目(2015A040404022,2014A020212200) 廣東省醫(yī)學(xué)生物力學(xué)重點(diǎn)實(shí)驗(yàn)室開放基金(2016MB003) 中山市科技計(jì)劃項(xiàng)目(2015B1264)
【分類號(hào)】：R687.3

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