三维可视化技术在Chevron手术治疗母外翻术前规划中的应用探讨

目的　探讨三维可视化技术在Chevron手术治疗母外翻术前规划中的应用价值。 方法　2014年1月至2015年12月本科室收治的20例轻度、中度母外翻患者，年龄48~72岁，行三维螺旋CT下0.625 mm薄层扫描，在M3D软件中三维图像处理系统上进行建模、模拟截骨，测量母 外翻角、第1，2跖骨间角，在不同截骨角度值下比较各测量值间的差异。 结果 数字化重建母 外翻模型、模拟截骨后按术前规划进行手术，与矫形后影像学表现进行比对，两者相符程度很高。AOFAS评分明显升高，患者满意度较高。 结论 三维重建母 外翻患者足部负重位模型可以清楚显示第1跖列在三维空间上的位置改变，为Chevron 截骨面设计，矫形后第1跖骨头的三维数据测量等提供量化依据。个性化制订母 外翻矫形手术方案，使足部形态及负重功能更好，术后患者满意度提高。

The application of three-dimensional visualization technique in preoperative planning of Chevron Osteotomy for treatment of hallux valgus

Objective　To Discuss the benefit of the three-dimensional visualization technique in preoperative planning of Chevron Osteotomy for treatment of hallux valgus.　Methods 　From January 2014 to December 2015, the 3D visualization preoperative planning technique was applied to 20 admitted patients aged 48-72 years old with mild to moderate hallux valgus. The image processing software M3d was performed to analyze the images obtained from 3D spiral CT with 0.625 mm thin slices, generate the hallux valgus model, simulate the osteotomy, measure hallux valgus angle (HVA) and 1st-2nd intermetatarsal angle (IMA), and compare measurements at different osteotomy angles.　Results　With the guidance of the preoperative planning made through digital reconstruction model of hallux valgus and osteotomy simulation, the imaging findings after osteotomy correction highly agreed with the one made from 3D virtual surgery. AOFAS scores were significantly increased, as well as patient satisfaction.　Conclusions　The 3D foot weight-bearing reconstruction model for hallux valgus patient clearly shows the position change of the first metatarsal column in a 3D space. It also provides a quantitative basis for Chevron osteotomy surface design and 3D post-treatment measurement of the first metatarsal head. Hallux valgus correction treatment should be designed to accommodate individual differences, so that the foot shape looks better and weight-bearing function works better to improve patient satisfaction after Chevron osteotomy.