健侧跟骨数字模拟仿真治疗跟骨关节内骨折.doc

健侧跟骨数字模拟仿真治疗跟骨关节内骨折【中图分类号】R684【文献标识码】A【文章编号】1672－3783(2011)08－0018－02 【摘要】目的 探讨健侧跟骨数字模拟治疗跟骨关节内骨折的疗效。方法 对32例单侧跟骨关节内骨折进行手术治疗，术前双侧跟骨行CT扫描并三维重建，模拟仿真制作患侧跟骨模型，测量跟骨长，前高、前宽、沟部高、沟部宽、后部高、后宽，Bolher角和Gissane’s角，预制好跟骨钢板大小和形状，以备术中用。结果 随访3-26个月，平均16±4.66个月，根据AOFAS评分标准，平均分为86.2分，其中优19足，良9足，可3足，差1足；优良率87.5%。结论 通过数字模拟仿真健侧跟骨，采用切开复位钢板内固定治疗跟骨关节内骨折，配合早期功能锻炼，能获得满意疗效。 【关键词】跟骨骨折；切开复位内固定；数字仿真 The treatment of calcaneal articular fractures by digital simulation of contralateral calcaneus Li Wenhu；Zhong Zhinian;Li Wenrui;Yuan Aidong;Shu Jiacang;Liu Rende;He Zhengyan;Zhang Heng 【Abstract】Objective: To evaluate the effect of the treatment of calcaneal articular fractures by digital simulation of contralateral calcaneus. Methods: 32 feet of 32 patients with one-side calcaneal articular fractures were treated by surgical operation, Anteroposterior,lateral,tangential radiographs ,CT scans and the three dimensional reconstraction were obtained in all patients preoperatively..The analog simulation manufactured the healthy side calcanerm model.We also measured calcaneum length, the front part height,extends，the height and width of ditch part，the height and extent of behind part,Bohler angle and Gissane’s angle,therefor,we can design the most suitable calcaneum steel plate size and the shape before the operation.Results: The patients were followed up with an average time of 16±4.66 monthes(range from 3 to 26 monthes).The effect of treatment was evaluated according to the AOFAS scores。The mean score of AOFAS was86.2,the results were excellent in 19,good in 9,fair in 3,and poor in 1 . Conclusion: The treatment effects of intraarticular calcaneal fractures by digital simulation of contralateral calcaneus are satisfactory. 【Key words】calcaneal fractures；open reduction and internal fixation；digit simulation 跟骨骨折是临床常见骨折之一，占全身骨折的2%，跗骨骨折的60%，致残率高达30%［1］。其中，70%-75%的跟骨骨折属于关节内骨折，由于其不规则的解剖，复杂的生物力学和纤薄的软组织覆盖等因素，使跟骨骨折的治疗存在很多争议。近年来，CT三维成像技术广泛的应用于临床，使任意层面重建达到了“等像素”（Iso―Voxe）。重建图像质量大大提高，在复杂关节内骨折的应用中