成人尺骨急性塑性弯曲的三维术前规划
Three-dimensional preoperative planning for adult acute plastic bowing of the ulna.
作者信息
Oki Satoshi, Inaba Naoto, Nagura Takeo, Yoshida Hirobumi
机构信息
Department of Orthopedics, Nasu Red Cross Hospital, Japan.
Department of Biomechanics, Keio University School of Medicine, Japan.
出版信息
Trauma Case Rep. 2020 Jun 28;28:100325. doi: 10.1016/j.tcr.2020.100325. eCollection 2020 Aug.
CASE
We report a case of adult acute plastic deformity of the ulna. Ulnar osteotomy was planned using 3-dimensional (3D) surface data from both injured and intact sides using surface registration technique. Opening wedge osteotomy was planned to correct the position of the ulnar fovea with respect to the proximal ulna. The position of the plate and direction of the screws were decided preoperatively. The operation was performed with reference to a 3D-printed, reduced model. The preoperatively limited pronation and supination of the patient were significantly improved as of 2 years postoperatively. Our preoperative method has several advantages. The risk of nonunion is low because the hinge-side bone cortex remains intact. The surgical procedure is simple, because plate position and direction of drilling are both decided preoperatively. In addition, correction of alignment can be achieved gradually by inserting screws through the plate and checking the range of motion of the forearm.
CONCLUSION
Our 3D preoperative simulation aimed to correct the rotational axis of the forearm. The surgical procedure was greatly facilitated using the 3D-printed, reduced model for reference.
病例
我们报告一例成人尺骨急性塑性畸形病例。使用表面配准技术，利用受伤侧和未受伤侧的三维（3D）表面数据规划尺骨截骨术。计划采用开放楔形截骨术来纠正尺骨凹相对于尺骨近端的位置。术前确定钢板位置和螺钉方向。手术参照3D打印的缩小模型进行。截至术后2年，患者术前受限的旋前和旋后功能得到显著改善。我们的术前方法具有几个优点。由于铰链侧骨皮质保持完整，骨不连风险低。手术过程简单，因为钢板位置和钻孔方向均在术前确定。此外，通过将螺钉穿过钢板并检查前臂活动范围，可以逐步实现对线矫正。
结论
我们的3D术前模拟旨在纠正前臂的旋转轴。使用3D打印的缩小模型作为参考极大地便利了手术过程。
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