数字化技术在骨科的临床应用  

Digital technology used in orthopaedic surgery

作　　者：张元智[1] 陆声[2] 赵建民[1] 王跃文[1] 刘瑞[1] 裴国献[3] 

机构地区：[1]内蒙古医学院附属医院骨科,呼和浩特010050 [2]成都军区昆明总医院全军骨科中心 [3]第四军医大学西京骨科医院

出　　处：《中华创伤骨科杂志》2011年第12期1161-1165,共5页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金（81160229）;内蒙古自然科学基金（2009MS1103）;内蒙古医学院科技百万工程（NY2011BW012）

摘　　要：目的探讨数字骨科学理论及数字化技术在骨科中的应用。方法数字骨科解剖学：获取健康成人下肢连续薄层CT扫描数据，三维重建股前外侧皮瓣结构并立体显示；获取健康成人髋、膝、踝关节连续薄层CT扫描数据，三维重建各关节后构建股骨头、膝关节、胫骨平台、踝关节中心，三维重建下肢的机械轴线。数字骨科手术设计与应用：获取12例成人单侧髋关节发育不良患者骨瓮连续螺旋CT扫描数据．三维构建患侧髋关节解剖旋转中心，设计髋臼侧假体最佳置入导航模板并应用于临床，验证结果。虚拟骨科仿真：获取8例男性志愿者腰椎螺旋CT扫描数据，三维重建L4.5椎体、椎间盘及韧带，建立Wallis系统模型，按标准手术模式与腰椎模型拟合，进行有限元前处理；选取单侧先天性髋关节脱位儿童1例，模拟Pemberton截骨矫形过程。结果重建的数字化模型可准确反映解剖学结构特点；快速成型导航模板有较好的匹配性，且操作易行、可靠；虚拟仿真可以再现手术方式及过程。结论重建的图像可以提供骨关节正常二维动态解剖，为“数字骨科学”概念的建立奠定了良好的基础。Objective To discuss digital technology used in orthopaedic surgery. Methods Dig- ital orthopaedic anatmny： 3D models of anterolateral femoral flap were reconstructed based on the 2D CT data of 6 adult volunteers using Amira 4. 1 software. Next, 8 aduh volunteers underwent continuous thin-layer chromatography scanning on the hip, knee and ankle joints. On the 3D reconstruction models of the joints, centers of the femoral head, the knee, tibia and the ankle were defined using Imageware 12. 1 software, and the mechanical axes of lower limb were determined. Digital orthopaedic operative procedure： The preoperative CT seans of 12 patients with hip arthodysplasia were used to reconstruct 3D models of the hip, on the basis of which rapid prototyping was applied to produce the navigation template used in the total hip arthroplasty. Virtual sinmlation： CT scan images of lumbar vertebrae were obtained from 8 adult male volunteers. 3D models of IA-5 and their discs and ligaments were reconstructed. The models of Wallis system were established and re-meshed to be transformed into Ansys 10.0 software for pre-processing. Next Pemberton osteotomy was simulated for an irffant with congenital dislocation of the hip. Results The 3D reconstruction models could perfectly display the anatomic relationships of the struc, tures. The template designs facilitated accurate placement of aeetabular emnponeuts in management of dysplasia of aeetabulum. Virtual simulation could reproduee the process of the orlhopaedic procedures. Conclusion All these studies and applieations of digital technology in orthopaedic surgery provide a convincing illustration of an important role of digital orthopaedics.

关 键 词：成像 三维 计算机辅助 模型 解剖学 

分 类 号：TP391.41[自动化与计算机技术—计算机应用技术] R687[自动化与计算机技术—计算机科学与技术]