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计算机辅助并行外固定架治疗复杂下肢畸形。

The computer-aided parallel external fixator for complex lower limb deformity correction.

机构信息

School of Control Science and Engineering, Hebei University of Technology, No. 8 Guangrong Road, Hong Qiao, Tianjin, 300130, China.

Rehabilitation Hospital, National Research Center for Rehabilitation Technical Aids, No. 1 Ronghua Middle Road, Da Xing, Beijing, 100176, China.

出版信息

Int J Comput Assist Radiol Surg. 2017 Dec;12(12):2107-2117. doi: 10.1007/s11548-017-1654-x. Epub 2017 Aug 7.

Abstract

PURPOSE

Since parameters of the parallel external fixator are difficult to measure and calculate in real applications, this study developed computer software that can help the doctor measure parameters using digital technology and generate an electronic prescription for deformity correction.

METHODS

According to Paley's deformity measurement method, we provided digital measurement techniques. In addition, we proposed an deformity correction algorithm to calculate the elongations of the six struts and developed a electronic prescription software. At the same time, a three-dimensional simulation of the parallel external fixator and deformed fragment was made using virtual reality modeling language technology. From 2013 to 2015, fifteen patients with complex lower limb deformity were treated with parallel external fixators and the self-developed computer software. All of the cases had unilateral limb deformity. The deformities were caused by old osteomyelitis in nine cases and traumatic sequelae in six cases. A doctor measured the related angulation, displacement and rotation on postoperative radiographs using the digital measurement techniques. Measurement data were input into the electronic prescription software to calculate the daily adjustment elongations of the struts. Daily strut adjustments were conducted according to the data calculated. The frame was removed when expected results were achieved. Patients lived independently during the adjustment.

RESULTS

The mean follow-up was 15 months (range 10-22 months). The duration of frame fixation from the time of application to the time of removal averaged 8.4 months (range 2.5-13.1 months). All patients were satisfied with the corrected limb alignment. No cases of wound infections or complications occurred.

CONCLUSIONS

Using the computer-aided parallel external fixator for the correction of lower limb deformities can achieve satisfactory outcomes. The correction process can be simplified and is precise and digitized, which will greatly improve the treatment in a clinical application.

摘要

目的

由于在实际应用中难以测量和计算平行外固定器的参数,本研究开发了一种计算机软件,可以帮助医生使用数字技术测量参数,并生成用于畸形矫正的电子处方。

方法

根据 Paley 的畸形测量方法,我们提供了数字测量技术。此外,我们提出了一种畸形矫正算法,用于计算六根支柱的伸长量,并开发了电子处方软件。同时,使用虚拟现实建模语言技术对平行外固定器和变形骨块进行了三维模拟。2013 年至 2015 年,我们使用平行外固定器和自行开发的计算机软件治疗了 15 例复杂下肢畸形患者。所有病例均为单侧肢体畸形。畸形由 9 例陈旧性骨髓炎和 6 例创伤后遗症引起。术后通过数字测量技术在 X 线片上测量相关的角度、位移和旋转。将测量数据输入电子处方软件,计算支柱的每日调整伸长量。根据计算出的数据进行日常支柱调整。当达到预期效果时,去除框架。患者在调整过程中独立生活。

结果

平均随访 15 个月(10-22 个月)。从应用到去除框架的固定时间平均为 8.4 个月(2.5-13.1 个月)。所有患者对矫正后的肢体对线都很满意。没有发生伤口感染或并发症。

结论

使用计算机辅助平行外固定器矫正下肢畸形可获得满意的效果。矫正过程简化且精确数字化,将大大提高临床应用中的治疗效果。

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