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用于髋臼手术的带有钻孔导向器的3D患者特异性植入物的设计、生产及临床应用。

The design, production and clinical application of 3D patient-specific implants with drilling guides for acetabular surgery.

作者信息

Merema B J, Kraeima J, Ten Duis K, Wendt K W, Warta R, Vos E, Schepers R H, Witjes M J H, IJpma F F A

机构信息

3D Lab/Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.

Department of Surgery, Subdivision of Trauma Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.

出版信息

Injury. 2017 Nov;48(11):2540-2547. doi: 10.1016/j.injury.2017.08.059. Epub 2017 Aug 30.

Abstract

An innovative procedure for the development of 3D patient-specific implants with drilling guides for acetabular fracture surgery is presented. By using CT data and 3D surgical planning software, a virtual model of the fractured pelvis was created. During this process the fracture was virtually reduced. Based on the reduced fracture model, patient-specific titanium plates including polyamide drilling guides were designed, 3D printed and milled for intra-operative use. One of the advantages of this procedure is that the personalised plates could be tailored to both the shape of the pelvis and the type of fracture. The optimal screw directions and sizes were predetermined in the 3D model. The virtual plan was translated towards the surgical procedure by using the surgical guides and patient-specific osteosynthesis. Besides the description of the newly developed multi-disciplinary workflow, a clinical case example is presented to demonstrate that this technique is feasible and promising for the operative treatment of complex acetabular fractures.

摘要

本文介绍了一种创新方法,用于开发用于髋臼骨折手术的带有钻孔导向器的3D患者特异性植入物。通过使用CT数据和3D手术规划软件,创建了骨折骨盆的虚拟模型。在此过程中,对骨折进行了虚拟复位。基于复位后的骨折模型,设计了包括聚酰胺钻孔导向器的患者特异性钛板,进行3D打印和铣削以供术中使用。该方法的优点之一是个性化钢板可根据骨盆形状和骨折类型进行定制。在3D模型中预先确定了最佳螺钉方向和尺寸。通过使用手术导向器和患者特异性骨固定术,将虚拟计划转化为手术过程。除了描述新开发的多学科工作流程外,还给出了一个临床病例示例,以证明该技术在复杂髋臼骨折的手术治疗中是可行且有前景的。

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