计算机辅助自动生成个性化先天性上尺桡融合矫形导板的设计  

Design of automatically generated patient-specific instrument guides for congenital radioulnar synostosis

作　　者：刘路 崔颖[3] 周天丰[3] 陈山林 Liu Lu;Cui Ying;Zhou Tianfeng;Chen Shanlin(Department of Hand Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Beijing Research Institute of Traumatology and Orthopaedics,Beijing 100035,China;School of Medical Technology,Beijing Institute of Technology,Beijing 100081,China)

机构地区：[1]首都医科大学附属北京积水潭医院手外科,北京100035 [2]北京市创伤骨科研究所,北京100035 [3]北京理工大学医学技术学院,北京100081

出　　处：《首都医科大学学报》2024年第5期815-822,共8页Journal of Capital Medical University

基　　金：北京市医院管理中心“登峰”计划项目(DFL20240402)。

摘　　要：目的使用数字化技术完成自动化骨性结构建模、截骨方案以及相应的矫形导板设计,对先天性上尺桡融合(congenital radioulnar synostosis,CRUS)的骨性结构进行精准矫正。方法对17例单侧患病的CRUS患者进行双前臂电子计算机断层扫描(computed tomography,CT),使用特征点识别算法进行骨性结构建模并自动规划截骨,根据截骨方案设计个性化截骨及接骨导板,并在实体模型上进行手术验证操作。结果使用个性化矫形导板可完成CRUS矫形手术操作,树脂模型手术操作结果与预期相符。截骨导板与骨表面的间隙、截骨导板厚度、接骨导板把手厚度、截骨沟槽宽度分别为3、4、9以及0.8 mm的截/接骨导板能更好且更准确地完成相应操作。结论数字化技术辅助自动生成的个性化导板可较好地辅助完成先天性上尺桡融合截骨矫形。Objective To establish automated bony structure modeling,osteotomy planning,and patient-specific instrument guides design for the precise osteotomy for congenital radioulnar synostosis(CRUS).Methods The computed tomography(CT)scan of bilateral forearms was performed on 17 patients with unilateral affected forearm.Bony structure modeling was performed using feature point recognition algorithms,and computer-aided design.The patient-specific osteotomy and osteosynthesis guides were designed based on the osteotomy plan,and the simulated surgery operation was performed on the resin model made using 3D printing and according to the digital model.Results Patient specific instrument guides can be used to perform CRUS osteotomy surgery,and the results of the resin model surgery are consistent with the expected outcome.The interval between the osteotomy guide plate and the bone,the thickness of the osteotomy guide plate,the thickness of the osteosynthesis guide plate handle and the width of osteotomy groove are 3,4,9,0.8 mm respectively.Such osteotomy/osteosynthesis guide plate can perform better and more accurately the corresponding operation.Conclusions The patient specific instrument guides automatically generated by the assist of digital technology can help surgeon to complete the osteotomy of CRUS.

关 键 词：数字骨科 先天畸形 截骨矫形 个性化矫形导板 

分 类 号：R682.5[医药卫生—骨科学]