摘要
目的 探讨胫骨平台骨折Schatzker分类三维数字化模型的建立及其在虚拟手术中的应用.方法 对健康男性志愿者行股骨下段及胫骨中上段64排螺旋CT扫描,所得数据应用Mimics10.01软件处理,重建出胫骨近端模型,依照胫骨平台骨折Schatzker分类的标准模拟出各型骨折.对骨折模型进行截图保存,并输出影片模式.胫骨平台骨折Schatzker分类骨折模型导入FreeForm Modeling System中,运用力反馈设备,进行虚拟骨折手术模拟.利用FreeForm Modeling System的GHOST开发出虚拟切割和骨折复位固定的软件,然后利用力反馈设备PHANTOM,对手术器械和骨折块进行操纵,模拟器械组装、钻孔、螺钉拧入、骨折复位、植骨等动作,完成骨折复位、内固定等手术操作.结果 胫骨平台骨折Schatzker分类三维数字化模型直观、立体、逼真,具有很好的视觉效果,可以从任意的方位和角度观察和截图,相对应的动画可以360°旋转观看.在FreeForm Modeling System 中,建立的虚拟手术环境具有很强的真实感、沉浸感和临场感,并有交互性和力反馈功能.使用者可以根据Schatzker分类每型骨折的特点决定手术方案、选择内固定物,在虚拟系统中进行反复的操作练习.结论 胫骨平台骨折Sehatzker分类的三维数字化模型具有直观、立体、逼真、动态等特点.使用胫骨平台骨折Schatzker分类虚拟手术系统可以使手术培训更加规范化、程序化和标准化,也可以作为临床手术前的规划和医患沟通的工具.
Objective To explore the establishment of Schatzker classification digital model of tibial plateau fractures and its application in virtual surgery. Methods Proximal tibial of one healthy male volunteer was examined with 64-slice spiral computed tomography （CT）. The data were processed by software Mimics 10. 01 and a model of proximal tibia was reconstructed. According to the Sehatzker classification criteria of tibial plateau fractures, each type of fracture model was simulated. Screen-captures of fracture model were saved from different directions. Each type of fracture model was exported as video mode. Fracture model was imported into FreeForm modeling system. With a force feedback device, a surgeon could conduct virtual fracture operation simulation. Utilizing the GHOST of FreeForm modeling system, the software of virtual cutting, fracture reduction and fixation was developed. With a force feedback device PHANTOM, a surgeon could manipulate virtual surgical instruments and fracture classification model and simulate surgical actions such as assembly of surgical instruments, drilling, implantation of screw, reduction of fracture, bone grafting and fracture fixation, etc. Results The digital fracture model was intuitive, three-dimensional and realistic and it had excellent visual effect. Fracture could be observed and charted from optional direction and angle. Fracture model could rotate 360 ~ in the corresponding video mode. The virtual surgical environment had a strong sense of reality, immersion and telepresence as well as good interaction and force feedback function in the FreeForm modeling system. The user could make the corresponding decisions about surgical method and choice of internal fixation according to the specific type of tibial plateau fracture as well as repeated operational practice in virtual surgery system. Conclusion The digital fracture model of Schatzker vlassification is inluilive, three-dimensional, realistic and dynamic. The virtual surget7 systems of Schatzker vlassifications make the virlual surgery training more normalized, programmed and standardized. In addition, virtual surgetT system can serve as a new tool for preoperative planning and surgeon-palient interactions.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第31期2478-2482,共5页
National Medical Journal of China
关键词
骨折
胫骨
模拟数字转换
计算机模拟
Fractures
Tibial plateau
Analog-digital conversion
Computer simulation
