摘要
目的数字化分析内踝斜形截骨相对于胫骨长轴的角度及3D打印个性化截骨导板的临床运用。方法对2015年3月至2016年3月通过PACS系统选择踝关节正位片和CT冠状面数据40例患者。测量胫骨远端关节面与内踝关节面交角的等分线角度,测量截骨平面相对胫骨长轴的交角。6例患者术前数字化截骨导板设计,将术后效果与术前设计效果进行比较。结果相对于胫骨远端关节面,其等分交角在X线片上平均角度是(57.4±1.8)°。CT前中后关节面等分交角分别为(58.7±1.5)°;(56.1±1.4)°;(58.6±1.7)°;平均(57.8±1.9)°。截骨线相对于胫骨长轴角度是(31.0±2.1)°。使用3D打印截骨导板患者术后X线片复查截骨关节面对合及螺钉位置良好,术后随访2年无局部创伤性关节炎的发生。结论内踝截骨与胫骨长轴平均角度31°截骨可获得良好匹配关节。使用3D打印个体化截骨导板辅助手术缩短手术时间,截骨准确,复位后关节面良好,具有可靠的稳定性。
Objective To explore the digital analysis of the angle of the medial malleolus oblique osteotomy relative to the long axis of the tibia and the clinical application of the 3 D printed personalized osteotomy guide.Methods From March 2015 to March 2016,40 patients were selected with PACS system for anteroposterior ankle joint and coronal CT data.The angle of the bisector of the angle between the articular surface of the distal tibia and the articular surface of the medial malleolus was measured.The angle of the osteotomy plane with respect to the long axis of the tibia was measured.Preoperative digital osteotomy guide plates were designed in 6 patients and the postoperative results were compared with preoperative design results.Results Relative to the distal tibial articular surface,the average angle of the bisection angle on the X-ray film was(57.4±1.8)°.The median angle of the anterior,middle and rear articular surface on CT was(58.7±1.5)°,(56.1±1.4)°,and(58.6±1.7)°.The mean angle was(57.8±1.9)°.The angle of the osteotomy line with respect to the long axis of the tibia is(31.0±2.1)°.The use of individualized 3 D printed osteotomy guide plate in the postoperative X-ray examination of the ankle joints and the position of the screws were satisfactory.No local traumatic arthritis occurred after 2 years of followup.Conclusions A medial malleolar osteotomy directed at a mean 31°relative to the tibial axis to the tibial cartilage,and will result in a congruent joint surface.The use of individualized 3 D printed osteotomy guide plates assisted the operation with reliable stability.
作者
黄雯洁
黄若昆
欧阳斐
赵晶晶
雷波
吴明正
张绍华
HUANG Wenjie;HUANG Ruokun;OUYANG Fei;ZHAO Jingjing;LEI Bo;WU Mingzheng;ZHANG Shaohua(Wuhan Fourth Hospital,Pu′ai Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430033,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第16期2673-2676,共4页
The Journal of Practical Medicine
