三维数字化骨科手术机器人在股骨颈骨折内固定钉道设计中的规划与测量  

Research on the planning and measurement of nail path of femoral neck fracture internal fixation based on 3D digital orthopedic surgery robot

作　　者：张孔源[1] 曹修恒 丁宁 王凤 王秋艳[1] 李慧[1] 刘建永[4] 胡强[5] ZHANG Kongyuan;CAO Xiuheng;DING Ning;WANG Feng;WANG Qiuyan;LI Hui;LIU Jianyong;HU Qiang(Department of Imaging,Weifang Peoples Hospital,Weifang 261041,China;Department of Imaging,Jinan Ninth People's Hospital;Imaging Teaching and Research Section,Weifang Medical University;Department of Orthopedics and Joint Surgery,Weifang Peoples Hospital;Department of Pediatric Surgery,Weifang Peoples Hospital)

机构地区：[1]潍坊市人民医院影像科,山东潍坊261041 [2]济南市第九人民医院影像科 [3]潍坊医学院影像学教研室 [4]潍坊市人民医院骨关节外科 [5]潍坊市人民医院小儿外科

出　　处：《潍坊医学院学报》2020年第6期429-431,F0003,共4页Acta Academiae Medicinae Weifang

基　　金：山东省重点研发计划资助课题(项目编号:2018GSF118161)。

摘　　要：目的分析影响基于CT与透视的骨科手术机器人内固定钉道规划误差的因素,探讨数字化定位规划的精准性。方法利用股骨颈骨折倒三角形内固定模型,选择股骨颈的最大平面,进行基于CT导航骨科手术机器人的钉道规划并测量其长度与角度;X线C型臂透视的钉道规划并测量其长度,对两者进行比较分析。结果基于CT导航骨科手术机器人规划的钉道测量:两底边顶点位置的钉道长度为(8.448±0.104)cm,(8.303±0.104)cm,倒三角形顶点位置的钉道长度为(8.567±0.071)cm,前倾角为(16.000±3.671)°,内倾角为(40.950±3.531)°,影响测量精确度的误差因素为测量选点。基于X线C型臂透视的规划钉道测量:两底边顶点位置的钉道长度为(7.996±0.119)cm,(7.996±0.119)cm,顶点位置的钉道长度为(8.870±0.126)cm,前倾角为(13.000±1.686)°,内倾角为(34.500±2.212)°。影响测量精确度的误差因素为切线位成像、投影成像、测量选点。结论三维数字化骨科手术机器人的钉道规划,真实反映钉道的空间角度与长度,适形分布,符合股骨颈的生物力学特性,定位精准、可靠。Objective Analyze the factors affecting the planning error of internal fixation nail path of orthopedic surgery robot based on CT and fluoroscopy,and to discuss the precision of digital navigation.Methods Using the inverted triangle internal fixation model of femoral neck fracture,the femoral neck was selected to obtain the maximum plane.Based on CT navigation orthopedic surgery robot to plan and measure the length and angle of the nail path;Based on X-ray C-arm fluoroscopy to plan and measure the length of the nail path.Compared and analyzed the two methods.Results According to the planning of CT guided orthopedic surgery robot:the nail track length at the two bottom of the inverted triangle was(8.448±0.104)cm and(8.303±0.104)cm,and the nail track length at the apex of the inverted triangle was(8.567±0.071)cm,the anteversion was(16.000±3.671)°,and that of the medial angle was(40.950±3.531)°.The factor that affects the measurement accuracy error was the selection of measurement points.Planned nail channel measurement based on X-ray C-arm fluoroscopy:the length of the nail track at the two bottom edges was(7.996±0.119)cm and(7.996±0.119)cm,the nail track length at the apex was(8.870±0.126)cm,the anteversion angle was(13.000±1.686)°,and the inclination angle was(34.500±2.212)°.The factors that affect the measurement accuracy were tangent position imaging,projection imaging and measurement point selection.Conclusion The nailing planning of 3 D digital orthopedic surgical robot truly reflects the spatial angle,length and distribution of the nail path,which conforms to the biomechanical characteristics of the femoral neck,and is an accurate and reliable digital positioning method.

关 键 词：骨科手术机器人 股骨颈 手术导航 计算机断层摄影 

分 类 号：R966[医药卫生—药理学]