计算机辅助下膝内翻截骨矫形的临床应用  

Computer simulation in tibal osteotomy for knee varus deformity

作　　者：柯晋[1] 张余[1] 马立敏[1] 阮征[1] 黄华扬[1] 夏虹[1] 尹庆水[1] 

机构地区：[1]广州军区广州总医院骨病关节科,广州510010

出　　处：《广东医学》2014年第1期61-63,共3页Guangdong Medical Journal

基　　金：全军医学科研"十二五"面上课题(编号:CWS11C268);广东省科技计划项目(编号:2007A060101003;2008A060101004)

摘　　要：目的探讨计算机辅助设计下膝内翻截骨矫形的术前评估、手术设计以及术后效果分析的可行性及术后随访的效果.方法选择12例（12膝）行股骨、胫骨截骨的患者,使用基于三维CT重建的计算机辅助技术,术前行双下肢全长站立正位、膝关节正侧位及双下肢全长螺旋CT扫描并进行三维重建,对下肢力线、股胫角及Lysholm评分进行评估.通过该程序对胫骨截骨术进行模拟操作,记录模拟手术中胫骨截骨的位置、截骨的角度作为实际手术的参考.术后复查膝关节正侧位X线及双下肢全长站立正位片对术后效果进行分析.结果术后随访3~24个月,所有患者患侧股胫角及胫骨角度均较术前明显减少,差异有统计学意义（P〈0.05）,Lysholm评分较术前明显提高,差异有统计学意义（P〈0.05）.结论基于三维CT重建的计算机模拟技术能够直观、立体地再现膝关节内外翻畸形的特点,与二维图像可互为补充,通过模拟截骨操作可使术者了解合适的截骨位置和截骨的角度,以指导实际的截骨手术.Objective To evaluate the application of computer simulation technique in tibal osteotomy for knee varus deformity in surgical planning and postoperative analysis. Methods The computer simulation technique was used on 12 knees in 12 patients with knee varus deformity for tibal osteotomy. Helical CT scan for the three - dimensional reconstruction was performed on all patients. The three - dimensional cross - section technology was adopted to evaluate the limb alignment, femorotibial angle and Lysholm＇s function scoring, and a special computer program was used to simulate the tibal osteotomy. Results After following - up for 3 to 24 months, the ipsilateral femorotibial angle and tibial angle of all patients were significantly reduced （P 〈 0. 05 ） , with increased Lysholm＇s function scoring （P 〈0. 05 ）. Conclusion The computer simulation technique is helpful in knee varus deformity measurement and surgical guidance.

关 键 词：计算机模拟 三维成像 膝关节内翻畸形 截骨术 

分 类 号：R684.705[医药卫生—骨科学]