利用Mimics软件对胫骨平台骨折骨缺失量估测的可行性研究
于树军;李辰;王敬博;臧家成;王裕民;
摘要(Abstract)：
[目的]使用数字医学三维重建探索评估胫骨平台骨折骨缺失量的新方法,并评估此方法的可行性。[方法]收集2009~2015年21例胫骨平台骨折患者,男14例,女7例;年龄24~64岁;左侧14例,右侧7例。按Schatzker分型:II型10例,III型1例,IV型3例,V型2例,VI型5例。运用MIMICS软件对患、健侧胫骨CT数据进行三维重建,并进行镜像、匹配、截骨、匹配度检测,计算健、患侧骨折块的体积差,即骨缺失量。将计算出的骨缺失量与术中实际植骨量进行比较,并进行配对t检验。[结果]21例患者骨折后丢失骨量体积平均[5.60±1.78(1.06~6.88)]cm~3。丢失体积占胫骨平台体积的比例为3.54%±2.09%(0.85%~8.23%)。体积差与术中植骨量比较,差异无统计学意义(P>0.05)。[结论]应用此方法对胫骨平台骨折骨缺失量进行估测,准确、简便易行,减少了手术时间。
关键词(KeyWords)： Mimics软件;胫骨平台骨折;骨缺失量
基金项目(Foundation):
作者(Author): 于树军;李辰;王敬博;臧家成;王裕民;
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参考文献(References)：
- [1]Elstrom JA,Virkus WW.Handbook of fractures[J].Third Ed.Medical Press,2006.
- [2]Tscherne H.Lobenhoffer P.Tibial plateau fractures.Management and expected results[J].Clin Orthop,1993,292(292):87-100.
- [3]Ding M.Age variations in the properties of human tibial trabecular bone[J].J Bone Joint Surg Br,1997,79:995-1002.
- [4]Muller ME,Allgower M,Schneider R,et al.Manual of internal fixation[M].2nded.New York:Springer,Rerlin Heidelberg,1979.
- [5]Savoie FH,Vander Griend RA,Ward EF,et al.Tibial plateau fractures.A review of operative treatment using AO technique[J].Orthopedics,1987,10:745-750.
- [6]Schatzker J,Mc Broom R.Bruce D.The tibial plateau fracture.The Toronto experience 1968-1975[J].Clin Orthop,1979,138(138):94-104.
- [7]Touliatos AS,Xenakis T,Soucacos PK,et al.Surgical management of tibial plateau fractures[J].Aeta Orthop Scand,1997,275(1):92-96.
- [8]Lachiewicz PF,Funcik T.Factors influencing the results of open reduction and internal fixation of tibial plateau fractures[J].Clin Orthop,1990,259(259):210-215.
- [9]Newman JT.Efficacy of composite allograft and demineralized bone matrix graft in treating tibial plateau fractures with bone loss[J].Orthopedics,2008,31(7):649.
- [10]Benirschke S,Swiontkowski,M.Knee.Orthop trauma protocol[M].Swiontkowski:Kate Raven Press,1993.
- [11]Russell TA,Leighton RK.Comparison of autogenous bone graft and endothermic calcium phosphate cement for defect augmentation in tibial plateau fractures.A multicenter,prospective,randomized study[J].J Bone Joint Surg Am,2008,90(10):2057-2061.
- [12]Pernaa K.Bioactive glass S53P4 and autograft bone in treatment of depressed tibial plateau fractures-a prospective randomized 11-year follow-up[J].J Long Term Eff Med Implants,2011,21(2):139-148.
- [13]Mauffrey C,Seligson D,Lichte P,et al.Bone graft substitutes for articular support and metaphyseal comminution:what are the options[J].Injury,2011,42(2):35-39.
- [14]Berkes MB.Outcomes of Schatzker II tibial plateau fracture open reduction internal fixation using structural bone allograft[J].J Orthop Trauma,2014,28(1):97-102.
- [15]Faour O,Dimitriou R,Cousins CA,et al.The use of bone graft substitutes in large cancellous voids:any specific needs[J].Injury,2011,42(2):87-90.
- [16]Finkemeier CG.Bone-grafting and bone-graft substitutes[J].J B one Joint Surg Am,2002,84:454-464.
- [17]Lewandrowski KU,Gresser JD,Wise DL,et al.Bioresorbable bone graft substitutes of different osteoconductivities:a histologic evaluation of osteointegration of poly(propylene glycol-co-fumaric acid)-based cement implants in rats[J].Biomaterials,2000,21(8):757-764.
- [19]Muschler GF.Evaluation of collagen ceramic composite graft materials in a spinal fusion model[J].Clin Orthop,1996,328(328):250-260.