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用于治疗犬肱骨髁间裂的三维打印患者特异性钻孔导向器的准确性。

Accuracy of three-dimensional printed patient-specific drill guides for treatment of canine humeral intracondylar fissure.

作者信息

Easter Tim G, Bilmont Alexis, Pink Jonathan, Oxley Bill

机构信息

Willows Referral Service, Solihull, United Kingdom.

出版信息

Vet Surg. 2020 Feb;49(2):363-372. doi: 10.1111/vsu.13346. Epub 2019 Nov 12.

Abstract

OBJECTIVE

To determine the accuracy of three-dimensional printed patient-specific drill guides (3D-PDG) as treatment of humeral intracondylar fissures (HIF) in dogs.

STUDY DESIGN

Retrospective consecutive case series.

ANIMALS

Client-owned dogs with HIF treated with a 5-mm transcondylar screw (TCS) placed from medial to lateral with a 3D-PDG.

METHODS

The proposed TCS entry point and trajectory were planned using computed tomography (CT) data and computer-aided design software (CAD), and a 3D-PDG was produced. During surgery the 3D-PDG was used to drill the pilot hole from medial to lateral; the guide was then removed, the pilot hole was overdrilled, and a 5-mm TCS was placed. Postoperative CT data were imported into CAD software, and the entry points, exit points, and trajectories were compared between the planned and actual screw locations.

RESULTS

Sixteen elbows from 11 dogs were included. Mean (SD) entry point translation was 1.3 mm (0.64), with all screws entering cranial to the proposed location. Mean maximum screw angulation was 5.2° (2.10°), with most screws directed caudodistal to the desired trajectory. Mean (SD) exit point translation was 1.8 mm (0.89) from the planned location. There was no intra-articular screw placement.

CONCLUSION

Use of a 3D-PDG permitted accurate placement of a mediolateral 5-mm locking TCS within the humeral condyle.

CLINICAL SIGNIFICANCE

Three-dimensional printed patient-specific drill guides should be considered as accurate and consistent for placing TCS for treatment of HIF in dogs.

摘要

目的

确定三维打印的患者特异性钻孔导向器(3D-PDG)用于治疗犬肱骨髁间骨折(HIF)的准确性。

研究设计

回顾性连续病例系列。

动物

由客户拥有的患有HIF的犬,使用3D-PDG从内侧向外侧置入5毫米髁间螺钉(TCS)进行治疗。

方法

利用计算机断层扫描(CT)数据和计算机辅助设计软件(CAD)规划拟用的TCS进针点和轨迹,并制作3D-PDG。手术过程中,使用3D-PDG从内侧向外侧钻导向孔;然后移除导向器,扩大导向孔,并置入5毫米TCS。将术后CT数据导入CAD软件,比较计划和实际螺钉位置的进针点、出针点和轨迹。

结果

纳入了11只犬的16个肘部。平均(标准差)进针点移位为1.3毫米(0.64),所有螺钉均进入到拟定位点的头侧。螺钉平均最大成角为5.2°(2.10°),大多数螺钉的方向为向尾侧远端偏离期望轨迹。平均(标准差)出针点移位距离计划位置为1.8毫米(0.89)。没有螺钉置入关节内。

结论

使用3D-PDG能够将5毫米的内外侧锁定TCS准确置入肱骨髁内。

临床意义

三维打印的患者特异性钻孔导向器在为犬放置TCS治疗HIF时应被视为准确且一致的工具。

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