胫骨平台骨折线的三维模型分析  

Three-dimensional model analysis of tibial plateau fracture lines

作　　者：邓朝阳 杨朝晖[1] Deng Zhaoyang;Yang Zhaohui(Department of Orthopedics,Second Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi Province,China)

机构地区：[1]山西医科大学第二医院骨科,山西省太原市030001

出　　处：《中国组织工程研究》2022年第3期334-339,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:胫骨平台骨折常由于其复杂的骨折类型及不满意的治疗结果,手术入路及治疗方法常不明确。临床常用骨折分型各有侧重,给临床医生的选择带来一定困难。近年来随着骨折地图绘制技术应用于临床研究,骨折地图研究越来越多。目的:重建胫骨平台骨折三维模型,分析骨折线特点。方法:回顾性研究133例胫骨平台骨折患者的病历资料,收集其原始影像资料,在Mimics 17.0软件中重建骨折模型,在3-matic 9.0软件中将重建的骨折模型复位并拟合到标准模板,在标准模板上临摹并叠加全部骨折线,分析骨折线分布规律。结果与结论:(1)胫骨平台骨折患者年龄大多分布于43-52岁(33.1%),其中男性患者骨折好发于43-52岁(35.4%),平均发病高峰为47岁;女性患者骨折好发于53-62岁(40.7%),平均发病高峰为52岁;(2)胫骨外侧平台骨折(81.8%)多于内侧平台(31.4%),骨折线主要集中在外侧平台内侧并延续至胫骨结节、Gerdy结节交界区(75.9%)和髁间嵴(71.5%),次要骨折线有3条,一条从髁间嵴向腓骨头前缘走行(21.2%),第2条沿前外侧平台外缘呈外弧形走行(13.8%),第3条从内侧平台前内侧向后外侧走行并延伸至外侧平台(15.3%);骨折线较少在胫骨结节(13.1%)、Gerdy结节(10.9%)、后内侧骨块(8.6%)、胫骨腓关节面(7.3%)出现;(3)结果表明,胫骨平台骨折有好发部位,临床中不能完全依赖某一骨折分型,需要个性化分析和治疗。BACKGROUND:Due to complex fracture types and unsatisfactory treatment results of tibial plateau fracture,the surgical approach and treatment methods are often unclear.The common clinical classification of tibial plateau fracture is different,which brings some difficulties to the choice of clinicians.In recent years,with more and more application of fracture mapping technology in clinical research,more and more studies on tibial plateau fracture mapping have been conducted.OBJECTIVE:To reconstruct the three-dimensional model of tibial plateau fracture and to analyze the characteristics of fracture lines.METHODS:A retrospective study was conducted in 133 cases of tibial plateau fractures.The original imaging data of patients were collected and used to reconstruct fracture model in Mimics 17.0 software.The reconstructed fracture model was reduced and fitted to the standard template and all fracture lines were delineated and superimposed on the standard template in 3-matic 9.0 software.RESULTS AND CONCLUSION:(1)Most patients of tibial plateau fracture were aged between 43 and 52 years(33.1%).Fractures in male patients mainly occurred between 43 and 52 years old(35.4%),and the average peak age of onset was 47 years;fractures in female patients mainly occurred between 53 and 62 years(40.7%),and the average peak age of onset was 52 years old.(2)The fracture line of lateral tibial plateau(81.8%)was more than that of medial plateau(31.4%).Fracture lines tended to occur mainly on the inner part of the lateral condyle that extended to the junctional zone between Gerdy’s tubercle and the tibial tubercle(75.9%),as well as intercondylar eminence(71.5%).There were three secondary fracture lines:One ran from the intercondylar eminence to the front of the fibular head(21.2%).The second line took an outer arc along the outer edge of the anterolateral tibial plateau(13.8%).The third line ran from the anteromedial to the posterolateral that extended to lateral tibial plateau(15.3%).Fracture lines were less likely to occur in the t

关 键 词：膝 创伤 胫骨平台骨折 骨折线 三维模型 CT 骨折地图 三维重建 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]