数字骨科技术在成人肘内翻畸形精确分析和三维矫形的初步应用:附3例报告  

Preliminary application of digital orthopaedic techniques in accurate analysis and 3D correction for cubitus varus deformity in adults:three cases report

作　　者：沈健坚 刘姮莹 丁焕文 涂强 王虹 SHEN Jianjian;LIU Hengying;DING Huanwen;TU Qiang;WANG Hong(Department of Spinal Orthopaedics,Guangdong Integrative Medicine Hospital,Foshan,Guangdong 528200,China;不详)

机构地区：[1]广东省中西医结合医院脊柱骨科,佛山528200 [2]南部战区总医院骨科医院,广州510010 [3]华南理工大学医学院,广州510006

出　　处：《中国骨科临床与基础研究杂志》2020年第2期112-117,共6页Chinese Orthopaedic Journal of Clinical and Basic Research

基　　金：广东省科技计划项目(2013B021800050)。

摘　　要：目的探讨数字骨科技术在成人肘内翻畸形精确分析和三维矫形的初步应用效果。方法对2011年7月至2012年8月南部战区总医院收治的3例成人肘内翻畸形患者进行螺旋CT扫描,将获取的双上肢骨骼二维图像数据导入Mimics 10.1软件,三维重建双上肢骨骼模型,在Imageware 12.3软件中建立健侧镜像模型,精确分析患侧三维畸形参数,采用计算机辅助设计截骨方式,模拟截骨矫形和内固定过程,通过立体光固化成型制作三维截骨模板,术中将模板与肱骨截骨部位相吻合,沿模板进行截骨、矫形和内固定置入。结果三维截骨模板与肱骨远端匹配良好。随访期间未发生伤口感染、神经损伤、内固定物失败、肘内翻复发和骨不愈合并发症,末次随访时按Mayo肘关节功能评分标准,3例患者均评定为优。结论采用数字骨科技术精确分析畸形参数、模拟截骨手术和制作三维截骨模板,能够为成人肘内翻畸形治疗提供精准的三维截骨方式。Objective To explore the preliminary applicable effect of digital orthopaedic technique in accurate analysis and 3D correction for cubitus varus deformity in adults.Methods Three cases of adult cubitus varus deformity admitted to General Hospital of Southern Theater Command from July 2011 to August 2012 were included in the study.All patients underwent spiral CT scan to obtain 2D image data of upper limbs which were imported into Mimics 10.1 software to reconstruct 3D skeleton models of upper extremities,mirror image models for healthy side of elbow were generated by Imageware 12.3 software,and then the 3D deformity parameters of the affected side of elbow were analyzed accurately.Computer-aided design was used to determine osteotomy mode,simulate the process of osteotomy orthopedics and internal fixation,and 3D osteotomy templates were made by stereo lithography appearance.During the operation,procedures of osteotomy,orthopedics and internal fixation were performed through the application of the templates which matched with the humeral osteotomy site.Results 3D osteotomy templates were matched well with the distal humerus.During the follow-up,no wound infection,nerve injury,failure of internal fixation,recurrence of cubitus varus or bone nonunion occurred.At the latest follow-up,the elbow function was evaluated by Mayo elbow function score,and all 3 cases were excellent.Conclusion Accurate analysis of deformity parameters,simulation of osteotomy procedure and usage of 3D osteotomy templates by digital orthopaedics techniques,could provide a precise 3D osteotomy method for the treatment of cubitus varus deformity in adults.

关 键 词：肘关节 畸形 截骨术 外科手术 计算机辅助 手术模板 成年人 

分 类 号：R682.5[医药卫生—骨科学] R687.31[医药卫生—外科学]