3D打印导向模板在复杂股骨转子下骨折内固定手术中的应用  

Design and research of three-dimensional printing guide template for internal fixation of complex femoral subtrochanteric fracture

作　　者：吴帆[1,2] 王越[3] 曹雷[2] 崔慧先[2] 

机构地区：[1]武警河北总队医院骨外科,河北石家庄050081 [2]河北医科大学解剖教研室,河北石家庄050017 [3]石家庄医学高等专科学校人体解剖与组织胚胎学教研室,河北石家庄050081

出　　处：《武警后勤学院学报（医学版）》2016年第1期37-40,44,F0003,共6页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】利用3D打印骨折模型设计最佳手术方式及步骤,利用3D打印手术导向模板进行辅助定位,为临床手术治疗提供一种新的方法和有效的辅助手段。【方法】选取1例复杂股骨转子下骨折患者进行双侧股骨螺旋CT扫描,将数据导入Mimics软件生成骨折数字三维模型。虚拟复位确定手术方案。应用3D打印机打印出骨折模型,进行模拟手术,并对选定的公版内置物进行预塑形。测量内置物详细参数,在Creo Parametric 2.0软件中得到内置物数字模型,导入3-matic 9.0中,安放在符合AO固定标准的位置,验证并确定进针点,在软件中建立与进针点周围骨皮质解剖形状一致的导向模板并打印出导板。另选取1份骨折模型,通过手术导向模板安装内置物来验证其可行性。【结果】建立了复杂股骨转子下骨折模型以及制作个体化手术导板的方法,制备出的导向模板具有较好的匹配性,适用于动力髁螺钉的固定。【结论】该方法缩短了手术的学习曲线,增加了手术固定的准确性和安全性。为手术医生术中快速、准确定位提供了一种新的方法,具有一定的临床应用价值。【Objective】To design the best operation mode and process via three- dimensional（3D） printing fracture model, assist operation location by using 3D printing guide template and provide a new and effective method for clinical surgery.【Methods】A patient with complex femoral subtrochanteric fracture was selected and scanned with bilateral femoral spiral CT. The image data were imported into Mimics software to generate digital 3D fracture model. The operation scheme was determined via virtual surgery in Mimics software. The fracture model was printed out by 3D printer. Then surgical operation was simulated to preliminarily shape the selected implant. Detailed parameters of the shaped implant were measured. The digital model of the implant was designed in Creo Parametric 2.0 and imported into 3-matic 9.0. The digital model was put in the position according with AO standard for testing and guiding wire point. The reverse template consistent with the bone cortex around the wire point was established in the software. The guide template was printed out by 3D printer. Another fracture model was selected. The feasibility of surgical guide template was validated by installing the implant.【Results】The digital model of complex subtrochanteric fracture and the preparation method of individual surgical guide template were established. The prepared guide template was of good compatibility and suitable for dynamic condylar screw fixation. 【Conclusion】 This method shortens the learning curve of complicated fracture surgery, increases the accuracy and security of surgical fixation and provides a new way for rapid and accurate location in surgery. It is valuable in clinical application.

关 键 词：3D打印 股骨转子下骨折 导向模板 增材制造 动力髁螺钉 

分 类 号：R683.42[医药卫生—骨科学]