复杂髋臼骨折复位及内固定的数字技术模拟研究

目的　探讨数字医学技术在复杂髋臼骨折复位及手术模拟中的应用。 方法　采集1例髋臼骨折患者的骨盆CT图像，在Mimics 14.01软件上进行三维重建，并利用Geomagic Studio 11.0软件进行骨折的复位和内固定的手术模拟，提出手术指导方案。术后三月再次采集患者骨盆CT图像，三维重建后与术前设计进行比较，评价应用数字技术开展复杂髋臼骨折的术前设计的效果。 结果　根据Tile分型：该病例为C2-3型。Mimics软件重建的骨盆三维模型可准确反映复杂性髋臼骨折的三维立体结构，利用Geomagic软件移动骨折碎片，进行骨折复位，并精确测量出相关的各项数据和进行内固定的放置设计。术后随访钢板与螺钉非常接近术前设计的位置。 结论　应用数字医学技术有助于直观地显示骨盆内部情况并明确分型，并能实现骨折复位及内固定模拟等操作，实现复杂髋臼骨折的术前设计，提高了手术精确性。

The digital simulation of fracture reduction and fixation of complicated acetabular fractures

Objective　To investigate the fracture reduction and implant simulation of complicated acetabular fractures using digital medical technologies. 　Methods　CT image of one case of complicated acetabular fractures was obtained and imported into software Mimics. Geometry models of pelvis were three-dimensionally (3D) reconstructed. Fracture Reduction and implant simulation were performed in software Geomagic, which served as a surgical guidance. The CT images of the same patient were obtained again 3 months after the operation. The postoperative models were also reconstructed for comparison and evaluation. Results　According to the Tile classification, the case was type C2-3. By using Mimics software, the 3D model accurately reflected the structure of pelvis with complicated acetabular fractures. With bone fragments being moved and rotated in Geomagic, fracture reduction and implant simulation were performed. The post-operation effect was good after following-up. The positions of plates and screws in pre- and post-operation stages were very close.　Conclusions　The digital medical technologies are very useful for fracture reduction and implant simulation, which can improve the accuracy of the surgery.