St Hilaire Hugo, Steele Thomas N, Delatte Stephen, Hebert Christopher K, Canizares Orlando
LSU Division of Plastic and Reconstructive Surgery, New Orleans, La.; Private Practice, Lafayette, La.; and Tulane University Division of Plastic & Reconstructive Surgery, New Orleans, La.
Plast Reconstr Surg Glob Open. 2014 Dec 5;2(11):e258. doi: 10.1097/GOX.0000000000000223. eCollection 2014 Nov.
Craniofacial reconstruction remains the main application for virtual surgical planning (VSP). We present a case in which this technology was applied to reconstruct a bony defect of the first metatarsal bone from a gunshot injury. VSP was used to facilitate a 1-stage reconstruction with a fibular osteocutaneous flap. A template of the reconstructed bone was designed based on the virtual mirror-image, noninjured bone. Prefabricated cutting guides facilitated precise shaping of the vascularized bone accounting for location of perforators. Successful reconstruction of the metatarsal bone was achieved with excellent functional outcomes. We believe that VSP can be a valuable tool in reconstruction of metatarsal bones by facilitating precise intraoperative shaping and anatomic orientation of the vascularized flap and reducing flap ischemia and operative time.
颅面重建仍然是虚拟手术规划（VSP）的主要应用领域。我们展示了一个案例，该技术被用于重建因枪伤导致的第一跖骨骨缺损。VSP被用于辅助采用腓骨骨皮瓣进行一期重建。基于虚拟镜像的未受伤骨设计了重建骨的模板。预制的切割导板有助于根据穿支位置对带血管骨进行精确塑形。成功实现了跖骨的重建，功能结果良好。我们认为，VSP通过促进带血管皮瓣的精确术中塑形和解剖定位，并减少皮瓣缺血和手术时间，可成为跖骨重建的一项有价值的工具。
