Vitković Nikola, Stojković Jelena R, Korunović Nikola, Teuţan Emil, Pleşa Alin, Ianoşi-Andreeva-Dimitrova Alexandru, Górski Filip, Păcurar Răzvan
Faculty of Mechanical Engineering, University of Nis, Aleksandra Medvedeva, 18000 Nis, Serbia.
Department of Mechatronics and Machine Dynamics, Faculty of Automotive, Mechatronics and Mechanical Engineering, Technical University of Cluj-Napoca, Blv. Muncii, No. 103-105, 400641 Cluj-Napoca, Romania.
Materials (Basel). 2023 Aug 2;16(15):5409. doi: 10.3390/ma16155409.
Proper fixation techniques are crucial in orthopedic surgery for the treatment of various medical conditions. Fractures of the distal humerus can occur due to either high-energy trauma with skin rupture or low-energy trauma in osteoporotic bone. The recommended surgical approach for treating these extra-articular distal humerus fractures involves performing an open reduction and internal fixation procedure using plate implants. This surgical intervention plays a crucial role in enhancing patient recovery and minimizing soft tissue complications. Dynamic Compression Plates (DCPs) and Locking Compression Plates (LCPs) are commonly used for bone fixation, with LCP extra-articular distal humerus plates being the preferred choice for extra-articular fractures. These fixation systems have anatomically shaped designs that provide angular stability to the bone. However, depending on the shape and position of the bone fracture, additional plate bending may be required during surgery. This can pose challenges such as increased surgery time and the risk of incorrect plate shaping. To enhance the accuracy of plate placement, the study introduces the Method of Anatomical Features (MAF) in conjunction with the Characteristic Product Features methodology (CPF). The utilization of the MAF enables the development of a parametric model for the contact surface between the plate and the humerus. This model is created using specialized Referential Geometrical Entities (RGEs), Constitutive Geometrical Entities (CGEs), and Regions of Interest (ROI) that are specific to the human humerus bone. By utilizing this anatomically tailored contact surface model, the standard plate model can be customized (bent) to precisely conform to the distinct shape of the patient's humerus bone during the pre-operative planning phase. Alternatively, the newly designed model can be fabricated using a specific manufacturing technology. This approach aims to improve geometrical accuracy of plate fixation, thus optimizing surgical outcomes and patient recovery.
在骨科手术中，恰当的固定技术对于治疗各种病症至关重要。肱骨远端骨折可能由伴有皮肤破裂的高能创伤或骨质疏松性骨的低能创伤引起。治疗这些肱骨远端关节外骨折的推荐手术方法包括使用钢板植入物进行切开复位内固定手术。这种手术干预在促进患者康复和减少软组织并发症方面起着关键作用。动力加压钢板（DCP）和锁定加压钢板（LCP）常用于骨固定，其中LCP肱骨远端关节外钢板是关节外骨折的首选。这些固定系统具有符合解剖学形状的设计，可为骨骼提供角稳定性。然而，根据骨折的形状和位置，手术过程中可能需要额外的钢板弯曲。这可能带来诸如手术时间增加和钢板塑形错误风险等挑战。为提高钢板放置的准确性，该研究引入了解剖特征方法（MAF）并结合特征产品特征方法（CPF）。MAF的应用能够开发钢板与肱骨之间接触表面的参数模型。该模型使用特定于人体肱骨的专用参考几何实体（RGE）、本构几何实体（CGE）和感兴趣区域（ROI）创建。通过利用这种根据解剖定制的接触表面模型，在术前规划阶段可对标准钢板模型进行定制（弯曲），使其精确符合患者肱骨的独特形状。或者，新设计的模型可以使用特定制造技术制造。这种方法旨在提高钢板固定的几何精度，从而优化手术效果和患者康复情况。
