应用Solidworks软件对胫骨平台骨折进行术前评估和虚拟手术的初步研究

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摘要目的探讨Solidworks软件在胫骨平台骨折术前评估和虚拟手术中的价值。方法将胫骨平台骨折患者的Dicom格式CT扫描图像数据导入MIMICS14.01软件，重建膝关节和胫骨平台骨折三维模型，拟合曲面后将Iges文件导入Solidworks2013软件生成CAD模型。对骨折情况进行立体多角度观察，对胫骨平台骨折平台塌陷程度、膝关节半脱位程度等进行三维数据测量及植骨量测算。在膝关节CAD模型上规划手术入路，充分暴露骨折端，模拟克氏针撬拨等方式行骨折复位，通过开窗打压植骨恢复关节面平整性，将复位成功的骨折模型用钢板螺钉系统进行内固定。结果重建的胫骨平台骨折三维可视化CAD模型可进行立体多角度观察和测量，初步实现了对胫骨平台骨折的术前评估，完成了以规划手术入路、暴露骨折端、模拟骨折复位、开窗植骨、内固定为主要步骤的虚拟手术。结论应用Solidworks软件能够重建胫骨平台骨折CAD模型，对骨折情况进行便捷和精确的术前评估，完成虚拟手术操作，将为临床工作提供可靠依据。

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关键词 ：胫骨平台骨折, Solidworks, 术前评估, 虚拟手术

Abstract：Objective To investigate the value of Solidworks software in preoperative evaluation and virtual surgery of tibial plateau fractures.Methods The Dicom format CT image data of tibial plateau fracture patients were inputted into MIMICS14.01 software，and 3D reconstruction of the knee and tibial plateau fractures were imputed into Solidworks 2013 software after fitting surface after the Iges format files.The fractures' CAD models were shown from different perspectives and measured accurately.We designed operative approaches，exposed fracture area，performed virtual reduction and internal fixation with computer.Results The CAD models of tibial plateau fractures showed us the details of fracture from different perspectives include the degree of comminution and displacement.We finished the preoperative evaluation of tibial plateau fractures，performed virtual surgery include designing surgical approaches，exposing the fracture area，simulate fracture reduction，fenestration and bone grafting and internal fixation.Conclusion Solidworks software can reconstruct the CAD models of tibial plateau fractures，achieve the fracture assessment and preoperative virtual surgery.Solidworks software will provide a reliable method and basis for clinical work.

Key words： tibial plateau fracture solidworks preoperative evaluation virtual surgery

基金资助:广州市增城区人民医院青年医学人才培育基金(2016QN03)

通讯作者: 黄建荣

作者简介: 郑翔(1989－ )，男，医师，广州市增城区人民医院，510300。

引用本文:

郑翔 1，许锦煌 1，黄建荣 2*. 应用Solidworks软件对胫骨平台骨折进行术前评估和虚拟手术的初步研究[J]. 实用骨科杂志, 2017, 23(10): 895-907.
Zheng Xiang 1，Xu Jinhuang 2，Huang Jianrong 2，et al. Preoperative Evaluation and Virtual Surgery of Tibial Plateau Fracture with Solidworks Software. sygkzz, 2017, 23(10): 895-907.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2017/V23/I10/895

［1］Dattani R，Slobogean GP，O'Brien PJ，et al.Psychometric analysis of measuring functional outcomes in tibial plateau fractures using the Short Form 36 (SF-36 )，short musculoskeletal function assessment (SMFA) and the western ontario mcMaster osteoarthritis (WOMAC) questionnaires［J］.Injury，2013，44(6)：825-829.
［2］Malakasi A，Lallos SN，Christos M，et al.Finite element method in internal and hybrid external fixation of tibial condylar fractures：a comparative application study［J］.J Long Term Eff Med Implants，2011，21(4)：261-267.
［3］Chen XZ，Liu CG，Chen Y，et al.Arthroscopy-assisted surgery for tibial plateau fractures［J］.Arthroscopy，2015，31(1)：143-153.
［4］Babis GC，Evangelopoulos DS，Kontovazenitis P，et al.High energy tibial plateau fractures treated with hybrid external fixation［J］.J Orthop Surg Res，2011，6(1)：1-7.
［5］Taylor J，Langenbach A，Marcellin-Little DJ.Risk factors for fibular fracture after TPLO［J］.Vet Surg，2011，40(6)：687-693.
［6］PratFabregat S，Camacho-Carrasco P.Treatment strategy for tibial plateau fractures：an update［J］.EFORT Open Rev，2016，1(5)：225-232.
［7］Kumar A，Whittle AP.Treatment of complex (Schatzker TypeVI) fractures of the tibial plateau with circular wire external fixation：retrospective case review［J］.J Orthop Trauma，2000，14(5)：339-344.
［8］Papagelopoulos PJ，Partsinevelos AA，Themistocleous GS，et al.Complications after tibia plateau fracture surgery［J］.Injury，2006，37(6)：475-484.
［9］Sirkin MS，Bono CM，Reilly MC，et al.Percutaneous methods of tibial plateau fixation［J］.Clin Orthop Relat Res，2000(375)：60-68.
［10］G-sling T，Klingler K，Geerling J，et al.Improved intra-operative reduction control using a three-dimensional mobile image intensifier-a proximal tibia cadaver study［J］.Knee，2009，16(1)：58-63.
［11］Yuan X，Xuan M，Tian W，et al.Application of digital surgical guides in mandibular resection and reconstruction with fibula flaps［J］.Int J Oral Maxillofac Surg，2016，45(11)：1406-1409.
［12］Silva DN，Gerhardt de Oliveira M，Meurer E，et al.Dimensional error in selective laser sintering and 3D-printingof models for craniomaxillary anatomy reconstruction［J］.Craniomaxillofac Surg，2008，36(8)：443-449.
［13］Terajima M，Nakasima A，Aoki Y，et al.A 3-dimensional method for analyzing the morphology of patients with maxillofacial deformities［J］.Am J Orthod Dentofacial Orthop，2009，136(6)：857-867.
［14］Bagaria V，Deshpande S，Rasalkar DD，et al.Use of rapid prototyping and three-dimensional reconstruction modeling in the management of complex fractures［J］.Eur J Radiol，2011，80(3)：814-820.
［15］章莹，夏远军，万磊，等.计算机三维仿真技术与常规手术治疗胫骨平台骨折的疗效对比分析［J］.中国骨与关节损伤杂志，2010，24(8)：686-688.
［16］李清泉，邹庆喜.胫骨平台复杂骨折虚拟手术三维重建治疗的临床效果研究［J］.临床和实验医学杂志，2014，13(22)：1909-1911.
［17］陈羽，宋烜，张海兵.三维重建及虚拟手术在复杂胫骨平台骨折治疗中的应用［J］.中国组织工程研究，2013，17(39)：6940-6945.
［18］付鑫，马信龙，马剑雄，等.Mimics软件在胫骨平台骨折分类及术前计划的初步应用［J］.中国中西医结合外科杂志，2009，15(4)：463-467.