计算机三维仿真技术在复杂足踝部骨折手术中的应用  

Application of computer aided 3D simulation technique for complicated foot and ankle fractures

作　　者：章莹[1] 夏远军[1] 万磊[1] 吴文[1] 谭新宇[1] 谢会斌[1] 刘汉辉[1] 尹庆水[1] 

机构地区：[1]广州军区广州总医院创伤骨科,510010

出　　处：《中国骨科临床与基础研究杂志》2010年第2期98-101,共4页Chinese Orthopaedic Journal of Clinical and Basic Research

基　　金：广东省自然科学基金团队项目(20023001)

摘　　要：目的探讨计算机三维仿真技术辅助个体化复杂足踝部骨折精确治疗的疗效。方法对2007年11月～2009年8月收治的255例复杂足踝部骨折患者进行手术治疗,其中123例采用传统手术治疗,另132例在术前CT图像三维重建、计算机三维模拟手术和个体化预手术的基础上实施精确化手术。对获得随访的196例患者(传统手术组91例,计算机辅助组105例)进行回顾性研究,比较两组术中复位固定时间及随访6个月时的踝关节功能(按美国足踝外科学会足部功能Hindfoot评分系统评定)。结果 196例患者获得6～36个月随访,平均随访时间12个月。其中计算机辅助组105例,传统手术组91例,复位固定时间分别为(44.3±5.4)min和(56.3±5.7)min,两组比较为差异有统计学意义(t=4.510,P=0.000);随访6个月时计算机辅助组踝关节功能评分(优60例,良35例,可10例,优良率90.4%)优于传统手术组(优39例,良32例,可14例,差6例,优良率78.0%),两组比较为差异无统计学意义(χ2=1.418,P=0.165)。结论计算机三维仿真技术辅助个体化手术可以降低术中复位固定时间,提高足踝部骨折手术的精确度,是治疗复杂性足踝骨折的有效方法 。Objective To investigate the effect of computer aided 3D simulation technique for treating complicated foot and ankle fractures precisely. Methods From November 2007 to August 2009, 255 patients with complicated foot and ankle fractures were treated surgically. Among these patients, conventional operations were performed in 123 cases （group 1）, and operations applied with preoperative CT images 3D reconstruction and simulation and individualized were performed in 132 cases （group 2）. For 196 patients who had follow-up more than 6 months, an retrospective study were underwent to compare reduction fixation time during the operation and ankle joint functions（according to Hindfoot evaluation system formulated by American foot and ankle surgery association） at 6 months follow-up between both groups. Results One hundred and ninety-six patients were followed up from 6 to 36 months with average 12 months. There were 105 cases in group 2 and 91 cases in group 1. The reduction fixation time was （44.3 ± 5.4） min and （56.3 ± 5.7） min respectively which the difference had statistical significance（t = 4.510, P = 0.000）. At 6 months follow-up, ankle joint functions of patients in group 2 （excellent in 60 cases, good in 35 cases, fair in 10 cases, the excellent and good rate was 90.4%） were better recovered than those in group 1 （excellent in 39 cases, good in 32 cases, fair in 14 cases and poor in 6 cases, the excellent and good rate was 78.0%） while there were no statistical difference between two groups （χ^2 = 1.418, P = 0.165）. Conclusion Computer aided 3D simulation individualized surgery can be used effectively to reduce reduction fixation time during the operation and to improve the surgical accuracy for complicated foot and ankle fractures.

关 键 词：骨折 足损伤 踝损伤 治疗 计算机辅助 

分 类 号：R687.3[医药卫生—骨科学]