数字骨科技术在桡骨远端骨折掌侧钢板的放置定位中的应用  

Digital orthopedic technology in the positioning of volar plate in distal radius fracture

作　　者：陈刚[1] 廉凯[1] 崔露[1] 吴农欣[1] 陆新颜[1] 王帮军[1] 陈枫文[1] 

机构地区：[1]湖北文理学院附属医院(襄阳市中心医院),湖北省襄阳市441021

出　　处：《中国组织工程研究》2014年第4期607-612,共6页Chinese Journal of Tissue Engineering Research

基　　金：襄阳市中心医院院级科研课题资助项目(YY20120C19)~~

摘　　要：背景:桡骨远端骨折以掌侧锁定钢板治疗为主,但尚存在操作中难以判断钢板位置同腕关节面边缘的距离,可导致螺钉穿出关节面的并发症。关节镜或操作中透视各有利弊,缺乏简单易行且有效的关于钢板放置定位的方法。目的:探索桡骨远端骨折掌侧锁定钢板的放置定位及计算机仿真在此治疗前规划的作用。方法:收集20例成人桡骨CT断层数据,通过MIMICS软件建模,在MIMICS中装配桡骨和掌侧钢板,测量最佳的关节面边缘同钢板远排螺孔中心的距离,求其标准差及均值。将桡骨远端骨折患者33例分为2组,常规规划组治疗前常规X射线及CT阅片,计算机规划组治疗前根据计算机测量的数据辅助规划。结果与结论:常用斜T型掌侧锁定钢板的安置安全区为:螺钉孔中心距关节面边缘均值男性为11.13 mm,女性为10.97 mm。计算机规划组患者治疗中透视次数及操作时间显著少于常规规划组(P<0.05)。提示计算机仿真技术可以有效确定桡骨远端掌侧钢板的适当位置,应用于治疗前规划中有助于减少老年骨折患者的透视及操作时间。BACKGROUND： Volar locking plate is the dominant treatment of distal radial fractures, but it is difficult to judge the distance between the plate position and the carpal articular surface, thus leading to screw penetration of the articular surface. Arthroscopy or operative perspective has their pros and cons, there is no simple and effective method of positioning the plate. OBJECTIVE： To find the optimal position of Volar LCP in distal radius fractures and explore the role of computer simulation in this treatment. METHODS： The CT data of the wrists in 20 adult patients were collected to calculate 3D models of the radius by MIMICS software. 3D model of the LCP was calculated by UG in working station. The distance between the plate and the distal radius joint was measured by computer simulation, and the mean value was calculated. A total of 33 Patients with distal radial fractures were divided into two groups： conventional treatment group （regular X-ray and CT） and computer simulation group （preoperative plan based on the computer-measured data）. RESULTS AND CONCLUSION： The safe distance between the screw center and the articular facet was 11.13 mm in males and 10.97 in females. The number of radiation and operating time were shortened significantly in computer simulation group （P 〈 0.05）. Experimental findings indicate that, computer simulation is a powerful tool to find the optimal position of volar LCP in the distal radius fractures. The time of the operation and X-ray fluoroscopy are also shortened significantly.

关 键 词：植入物 数字化骨科 计算机模拟 计算机辅助 桡骨远端骨折 掌侧锁定钢板 内固定 

分 类 号：R318[医药卫生—生物医学工程]