个性化三维打印仿生骨骼术前诊断模型  

Three dimensional fabrication custom-made bionic bone preoperative diagnosis models for orthopaedics surgeries

作　　者：汪焰恩[1] 李欣培[1] 杨明明[2] 魏庆华[1] 李川川[1] 张伟凡 魏溢 魏生民[2] 

机构地区：[1]西北工业大学机电学院工业工程系,西安710072 [2]西北工业大学现代设计与集成制造教育部重点实验室,西安710072

出　　处：《中国科学：信息科学》2015年第2期235-247,共13页Scientia Sinica(Informationis)

基　　金：国家自然科学基金(批准号:51175432;50905147);高等学校博士学科点专项科研基金(批准号:20116102110046);中央高校基本科研业务费专项资金(批准号:3102014JCS05007);西北工业大学研究生种子基金(批准号:Z2014037)资助项目

摘　　要：目前骨科临床手术利用CT数字图像诊断病案、规划手术方案及复位策略,不易在术前进行操作练习,所选取的内固定骨钉和骨板无法测定力学匹配,从而难以避免术后应力并发症.术中依赖手术医生的经验和工具反复测量以便准确选取内固定器械,从而延长了患者创面开放时间,增加术中静脉血栓甚至动脉血栓并发症几率.尤其对于血管和神经丰富的股骨头更是容易引起术中并发症,甚至致残致死.本文分析了骨骼解剖模型的结构,研究了骨骼的内部微细结构、术前诊断模型外形轮廓以及力学性能的仿生设计方法,在此基础上,通过控制三维打印工艺、粉体材料成分和材料参数,得到不同力学性能的骨支架,从而实现了个性化定制的全骨仿生术前诊断模型.利用该模型可有效反映病患骨折和骨缺损真实特点,并可增加观察视场,明确骨折和骨缺损的实际情况和病症分型,从而有助于制定固定骨钉和骨板实际操作方案和规划替代骨植入方案,为术前手术设计、复位模拟、内置物选择、三维数据测量等重要手术环节提供物理操作模型,可明显改善手术效果,有效缩短手术时间,减少术中和术后并发症几率.Before performing bone surgery, a diagnosis is obtained mainly based on CT digital images. It is impossible for surgeons to test their operation plans and recovery strategy before surgery. Choosing between strength-match bone nails and bone plates is difficult, and post-operative stress complication is inevitable. Surgeons need to measure defect areas carefully in order to choose appropriate internal fixation devices based only on experience. Consequently, surgery time increases. Longer surgery time means a higher possibility for vein thrombosis or even artery thrombosis. In addition, for caput femoris, which contains many vessels and nerves,a long surgery is more likely to cause intraoperative complications, disability, or even death. A 3DP customized bone preoperative diagnosis model can characterize a given fracture or defect precisely, and thus increase the observation field of view before surgery. This paper first analyze the model structure of skeletal anatomy, and then study the skeletal bionics design of the internal micro structure, the preoperative diagnosis outline shape structure, and the biomechanical property. Based on this study, we fabricate different strength bone scaffold by controlling the 3DP processing parameters, materials size and their shape. The preoperative diagnosis model can help surgeons define the level and type of bone defects. It facilitates choosing between bone nails and bone plates.The preoperative model can also be used as basis to set up bone nails, bone plates, and bone substitute implanting plans. As a physical model for preoperative design, recovery simulation, implant choice, and 3D spatial data measurements, the 3DP preoperative diagnosis model can substantially improve the effect of surgery, decrease surgery time, and consequently, decrease the possibility of intraoperative and post-operative complications.

关 键 词：三维打印 个性化定制 全骨仿生 骨科 术前诊断模型 

分 类 号：R687[医药卫生—骨科学] TP391.7[医药卫生—外科学]