肱骨近端四部分骨折的数字化术前模拟手术规划(1)
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[摘要] 目的 研究根据CT数据在个人计算机上对肱骨近端四部分骨折进行术前模拟手术规划的可行性及其临床意义。方法 对5例肱骨近端四部分骨折进行模拟手术规划。将肱骨近端骨折CT扫描原始数据导入Mimics及UG软件中，进行计算机术前模拟手术。根据接骨板长度、放置位置、螺钉长度、入钉方向及数量对比模拟手术与实际手术情况是否相符。结果 5例肱骨近端四部分骨折均成功完成模拟内固定。接骨板长度符合率100%；1例接骨板放置位置略向前移；螺钉长度符合率96.36%，螺钉方向符合率98.18%，螺钉数量符合率100%。结论 利用个人计算机辅助术前模拟肱骨近端骨折手术情况与实际手术情况基本相符，对肱骨近端骨折术前计划制定有良好的临床应用价值。
[关键词] 肱骨近端骨折；骨折固定术；数字化；三维手术模拟
[中图分类号] R445.3 [文献标识码] B [文章编号] 1673-9701(2011)22-24-02
Digital Preoperative Planning for Proximal Humeral Fractures of Neer’s Ⅳ
HE Jinyang1 ZHANG Yunpeng2 REN Longtao3
1.Shanxi Medical University，Taiyuan 030001，China；2.Affiliated Peace Hospital of Changzhi Medical Colleage，Changzhi 046000，China；3.Taiyuan City Central Hospital，Taiyuan，030009，China.
[Abstract] Objective To research the feasibility and clinical significance of computer-assisted preoperative design for proximal humeral fractures of Neer’s Ⅳ based on CT scanning date. Methods The simlation of preoperative design was performed for 5 cases of proximal humeral fractures of Neer’s Ⅳ. CT scanning date of proximal humeral fractures were imported into Mimics and UG software for computer-assisted preoperative design. The simulated preoperative design on the 3D model was compared with real operation in terms of the blade plate length，fixation position and the screws length，number. Results 5 cases of proximal humeral fractures of Neer’s Ⅳ were performed internal fixation of plates successfully. Coincidence rate of the length of the bone plate is 100%，coincidence rate of the length of the screw is 96.36%，coincidence rate of the direction of the screw is 98.18%，coincidence rate of the number of the screw is 100%. Conclusion The simulation of preoperative design matched well with real operation and computer-assisted preoperative design for proximal humeral fractures of Neer’s Ⅳis feasible and clinically significant.
[Key words] Humeral proximal fractures；Fracture fixation；Digitalization；Three-dimensional surgical simulation
肱骨近端骨折是一种常见的上肢骨折类型。按照Neer分型[1]，四部分骨折需手术治疗，本研究对5例肱骨近端四部分骨折采集CT原始数据进行计算机辅助术前模拟手术规划，并与实际手术情况对比。
1 材料和方法
1.1 材料
1.1.1 实验数据 选取5例肱骨近端Neer分型四部分骨折男性患者术前CT扫描(扫描条件：Toshiba aquilion 64排螺旋CT薄层扫描，电压120kV，电流120mA，层厚0.5mm ......
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