髋臼四方区解剖型自锁定钢板的数字技术设计  

Digital design of general anatomic self-locking plate for medial acetabulum

作　　者：李明[1] 张雁儒[2,3] 肖靖炜 张启平 徐丁 汪帅伊 LI Ming;ZHANG Yanru;XIAO Jingwei;ZHANG Qiping;XU Ding;WANG Shuaiyi(Department of Traumatic Orthopedics,Ningbo No.6 Hospital,Ningbo 315042,China;Institute of Orthopedics,Henan Polytechnic University,Jiaozuo 454001,China;School of Medicine,Ningbo University,Ningbo 315211,China;Ningbo Institute of Materials Technology&Engineering,CAS,Ningbo 315201,China)

机构地区：[1]宁波市第六医院创伤骨科,浙江宁波315042 [2]河南理工大学骨科研究所,河南焦作454001 [3]宁波大学医学院,浙江宁波315211 [4]中国科学院宁波材料技术与工程研究所,浙江宁波315201

出　　处：《宁波大学学报（理工版）》2022年第1期18-25,共8页Journal of Ningbo University：Natural Science and Engineering Edition

基　　金：浙江省医药卫生科技计划项目(2018PY059);宁波市鄞州区科技计划项目(2017YZQ102)。

摘　　要：为探讨使用数字技术设计新型髋臼四方区自锁定解剖型钢板,采集宁波市第六医院影像科2020年1月至2020年12月,25~50岁正常男女骨盆CT数据,选择中位数的骨盆CT作为模型.将CT数据依次导入Mimics软件和Unigraphics NX软件,生成三维骨盆模型.用CAD软件画出钢板螺钉dwg格式二维图像后导入UnigraphicsNX软件,建立stl格式钢板螺钉三维模型,设计钢板厚2.0~3.0 mm,实心皮质骨螺钉Ф3.5/5.5 mm.在三维空间视图中,将钢板螺钉装配到骨盆模型,重点观察三维透视图、钉道纵轴切面图、螺钉与钢板的锁定角度,校对功能固定区、定位孔、阻挡孔、固定孔、应力桥、滑动槽等指标,优化钢板形态和螺钉钉道,一块钢板同时固定髋臼四方区、臼顶负重区、前后柱、前后壁. stl格式数据输出至打印机, 3D打印钢板,装配到骨盆模型,校对钢板与骨盆的匹配度,确定最优化的图像数据.根据患者骨盆CT导出的数据,用Unigraphics NX软件建立三维骨盆模型,可灵活设计钢板螺钉,精度达到0.2 mm,即刻修改钢板螺钉形态数据,虚拟内固定.数字技术设计不再需要手工标本测量和CT图像测量,可提高新型内固定装置的设计效率,为个性化骨科内植物设计、精准固定手术提供了新路径.This study investigated the design of a new acetabular quadrilateral self-locking anatomical plate using digital technology. The pelvic CT data of normal men and women aged 25-50 years were collected in the Department of Imaging of Ningbo No.6 Hospital from January 2020 to December 2020. According to the Interquartile Range(IQR) principle, median pelvic CT was selected as the model. CT data were imported into Unigraphics NX software to generate 3 D pelvic model. The 2 D drawings of the plate and screw were first created in CAD and then imported into Unigraphics NX to establish their corresponding 3 D models. In a three-dimensional view, plate and screws were assembled into the pelvic model. In the three-dimensional perspective view, the longitudinal trajectory of the screw, and the locking angle between the screw and plate were observed. The accuracy indexes of “functional fixed region, positioning hole, buttress hole, fixed hole,stress bridge, sliding groove” were optimized. One single plate simultaneously fixed the medial region,weight-bearing dome, anterior and posterior regions of the acetabular joint. Based on this approach, the 3 D pelvic model can be established with data derived from the patient’s pelvic CT by Unigraphics NX. The plate and screws can be flexibly designed with the accuracy up to 0.2 mm. The shape data of the device can be immediately modified and the virtual internal fixation can be achieved. This digital design method does not require manual cadaver specimen measurement and CT image measurement, hence it improves the design efficiency of new internal fixation devices, and provides a new application technology path for personalized implant design and precise fixation surgery.

关 键 词：髋臼骨折 髋臼四方区 骨折固定 钢板 内固定 

分 类 号：R608[医药卫生—外科学]