计算机三维仿真技术辅助复杂足踝部骨折的治疗_29040.doc

计算机三维仿真技术在复杂足踝部骨折手术中的应用 章莹1，夏远军1，万磊1，吴文1，谭新宇1，谢会斌1，刘汉辉1 ，尹庆水1 【摘要】目的：探讨计算机三维仿真技术辅助个体化的复杂足踝部骨折精确治疗的疗效。方法：132例足踝部骨折患者术前进行CT图像三维重建，计算机三维模拟手术，快速成型与个体化标本预手术，123例足踝部骨折患者直接采用传统手术治疗，对获得随访的病例进行回顾性研究，记录两组术中复位固定时间，按照美国足踝外科学会足部功能评分系统评估术后踝关节功能。结果：随访时间6-36(18±3)个月，计算机辅助组获得随访105例，优60例，良35例，可10例，差0例，优良率90.4%，复位固定时间为（44.3±5.4）， 常规手术组获得随访91例，优39例，良32例，可14例，差6例，优良率78.0%，复位固定时间为（56.3±5.7）。与传统手术组相比，计算机模拟手术组复位固定时间明显降低，有统计学意义（P0.05）,术后优良率也较传统手术组高，但没有统计学意义。结论：计算机三维技术辅助是个体化手术治疗足踝骨折的有效方法，能有效减少术中复位固定时间并提高踝部骨折手术的精确度。 【关键词】三维仿真；足踝部骨折；撬拨复位 Computer aid designed operation of complicated fracture of foot ankle by 3d simulation technique ZHANG Ying1 ,Xia Yuanjun1, WAN Lei1 , Wu Wen1, Xie Huibin1, Liu Hanhui1, TAN Xin-Yu1, YIN Qing-Shui1, (1、Department of Orthopedics，Guangzhou General Hospital of Guangzhou Command, Guangzhou 510515, Guangdong, China) 【Abstract】Objective To precisely treat fracture of foot ankle by 3d simulation through computer aid designed operation and make comparison with those which were treated by simple operation. Methods The CT images of foot ankel fracture of 132 patients were imputed into computer for 3d reconstruction, then the dysplastic height were measured and bone grafting amout were predicted . According to the height and amout surveyed by computer, individual operation program were made, then the operation were done under C-arm fluoroscopy . 123 patients were treated through conventional operation not by computer aid. Time of fracture reset were recorded in operation. Ankle 1广州军区广州总医院骨科，广州，510010 【基金项目】：广东省自然科学基金团队项目； 【作者简介】：章莹 (1964-)，男，主任医师，硕士导师，研究方向：创伤与关节外科 。 电话: 020 E-mail:zhangying_doc@ function were assessed by Hintfoot scores after operation in two groups. Results 105 patients in computer-aided group and 91 patients in no computer-aided group were followed up from 6 months to 36 months, 17 months averaged. six months after operation, the ankle function were evaluated according Hintfoot scoring system. 39 patients were excellent, 32