摘要
目的评价计算机辅助带锁髓内钉固定胫骨骨折全程手术规划系统的有效性及临床可行性。方法在分析系统结构和操作流程的基础上,利用塑料胫骨模型(9根)和尸体胫骨(12具下肢肢体)进行基于C型臂透视图像的术中骨折肢体图像拼接、骨折闭合复位及髓内钉置入仿真测量实验；利用胫骨模型及尸体胫骨进行图像拼接精度分析,以验证图像拼接与规划模块的正确性。利用尸体胫骨进行计算机辅助骨折闭合复位试验,分析骨折复位机构模块的操作可行性。结果图像拼接模块只需术中采集7～10张有效的C型臂图像即可拼接出下肢长骨的全景图像,为采集图像所需的术中透视时间为(19．75±0．61)s；计算机进行X线透视图像采集和拼接总时间为(4．17±0．86)min；塑料模型拼接精度达(1．26±0．76)mm。结论该系统实现了基于C型臂拼接图像的计算机辅助胫骨骨折髓内钉内固定全程手术规划,术中可完成骨折复位图像分析、手术规划、虚拟仿真,髓内钉型号选择以及骨折复位等关键操作,为计算机辅助骨科手术系统治疗长骨骨折搭建了精确、安全、稳定的软硬件技术平台。
Objective To evaluate the efficacy and clinical feasibility of the computer-assisted full planning system for tibial fracture treatment with intramedullary nailing. Methods After analyzing the functional structure and operative procedures of the system, nine plastic tibia and 12 cadaver lower limbs were used for image mosaicing based on C-arm （PHILIPS BV Libra） fluoroscopic images in the operation room to assess the correctness of the mosaicing and planning algorithms. The plastic tibial model was used for analysis of the mosaicing precision. The cadaver tibial bone was used for reduction experiment with the reduction mechanism to analyze the operation feasibility. Results Only 7 to 10 [fluoroscopy time： （ 19.75 ± 0. 61 ） s] valid C-arm projection images were needed to produce a long bone panorama of the lower limb. The total time for image acquisition and mosaicing was within （4. 17±0. 86）minutes and the mosaicing precision in the plastic tibial model was （1.26±0. 76） mm. The operation of the reduction mechanism was very simple and could be controlled by a surgeon automatically or free of hand. An integrated reduction strategy could be produced for rough positioning in general and elaborate operations in details. Conclusion The computer-assisted full planning system can be used for anatomical analysis based on the C-arm panorama, full surgical planning, virtual simulation, selection of proper intramedullary nails and fracture reduction in treatment of long bone fractures.
出处
《中华创伤骨科杂志》
CAS
CSCD
2006年第12期1149-1152,共4页
Chinese Journal of Orthopaedic Trauma
基金
国家863高技术研究发展计划资助项目(2004AA-421022)
关键词
计算机辅助骨科手术
骨折牵引
C型臂透视
图像拼接
Computer-assisted orthopaedic surgery
Fracture traction
C-arm fluoroscopy
Image mosaic
