股骨颈骨折空心钉内固定的数字化方案关键技术  

Study on the Key Technology of Internal Fixation of Hollow Nails in Treating the Femoral Neck Fracture by Digital Design

作　　者：郑锋[1] 陈宣煌[1] 蔡涵华[1] 张国栋[1] 林海滨[1] 高小强[1] ZHENG Feng;CHEN Xuanhuang;CAI Hanhua;ZHANG Guodong;LIN Haibin;GAO Xiaoqiang(Department of Orthopedics,The Affiliated Hospital of Putian University,Putian Fujian 351100,China)

机构地区：[1]莆田学院附属医院骨科,福建莆田351100

出　　处：《莆田学院学报》2020年第5期55-58,68,共5页Journal of putian University

基　　金：福建省自然科学基金资助项目(2018J01194);福建省临床重点专科建设项目(2018145);莆田市科技计划项目(2019S3F005);莆田市科技局科研创新专项项目(2019SZP03)。

摘　　要：探讨三枚空心钉数字化内固定股骨颈骨折的关键技术。22侧下肢标本,进行CT薄层扫描,Mimics15.0软件三维重建、设计、编辑、测量等,设计并3D打印含钉道的导向模块,术中导航三枚空心钉置入,术后再次CT扫描,对数字化设计与实际手术术后结果的数据分别进行三维配准,统计分析两者的一致性。共置入螺钉66枚,置钉准确率100%。按偏移值每1 mm递增的精度要求统计,卡方检验结果显示进钉点精度可达到3.4 mm,出钉点精度为5.6 mm。结果表明,术前数字化设计,术中3D打印技术辅助实施,可实现股骨颈骨折空心钉内固定手术个体化,符合精准手术要求。This paper discusses the key technology used in digital internal fixation of three hollow screws for the femoral neck fracture.Twenty-two sides of lower limb specimens are scanned through thin layer CT.The data is obtained with the aid of Mimics software by 3D reconstruction,3D design,3D editing,three-dimensional measurement,etc.A navigational template with a nail path is designed and 3D printed.Intraoperative navigation helps to place the three hollow screws and a CT scan is done again after the operation.A three-dimensional registration is performed respectively for the data of the digital design and of the actual postoperative result,and a statistical analysis is made on the consistency of both data.A total of 66 screws are inserted,and the accuracy rate of screw placement is 100%.According to the requirement of increasing precision for each 1mm offset value,the chi-square test results show that the precision of the incoming stitching point can reach 3.4 mm,and that the precision of the outgoing stitching point is 5.6 mm.It shows that the digital design before the operation and the adjuvant implementation of 3D printing technology during the operation contribute to the individualization of the hollow nail internal fixation operation for the femoral neck fracture,which meet the requirements for the surgical accuracy.

关 键 词：股骨颈 内固定 数字化设计 3D打印 

分 类 号：R683.42[医药卫生—骨科学]