摘要
目的: 探究计算机三维重建技术在模拟骨盆、确定恶性肿瘤切除范围、假体个体化设计等方面的意义及实际应用效果。材料及方法: 女性髋臼软骨肉瘤1例, 病灶侵蚀髋臼底、髂骨、坐骨, 盆腔内软组织浸润约10cm。作病灶及骨盆的CT扫描, 计算机三维重建, 运用激光快速成型技术, 制出实物骨盆模型。根据模型确定截骨范围及截骨标志点, 模拟病灶切除。继续通过计算机, 制作与切除病灶相匹配的髋臼假体, 附带与周围骨盆组织完全服贴的固定柄。通过假体与患者肿瘤骨盆模型模拟手术与假体装备。取Smith Peterson及Radley联合入路, 显露髋关节、耻骨支、坐骨支, 按三维重建模型标志点切除肿瘤、植入预制假体; 假体分别以髂骨翼、耻骨、坐骨残余部分牢固固定。骨水泥固定髋臼内衬, 置换股骨头。结果: 手术时间约7h, 出血约2 000ml, 摄片示肿瘤缺损消失, 人工假体与骨盆和谐匹配, 髋关节活动良好。未出现神经损伤、深静脉栓塞、感染、脱位等现象, 患者恢复良好。结论: 计算机三维重建技术可以为髋臼肿瘤的恰当切除、匹配髋臼假体的个体化制作及骨盆的良好重建提供指导。
Objective:To evaluate the significance and effect of computer three dimension(3D) reconstruction in pelvic modeling,region of tumor resecting,designing of personal prothesis and the performing of the operation.Method:One case of a woman with acetabular chondrosarcoma,wich erosed the base of acetabulum,the ilium,the ischium and soft tissues in pelvic kidney was infiltrated about 10cm.The three dimension(3D) reconstruction of the pelvic and disease area was made.A pelvic modeling was made according to the 3D reconstruction.Based on the model,the tumor was resected appropriately and a matching personal prosthesis was made and used to reconstruct the defect caused by tumor resection.Smith-Petson with Radley approaches was used.The tumor resecting and personal prosthesis inserting was just similar to the modeling process on the 3D reconstruction.Then the prosthesis was fixed with correspondent residual bones and the acetabular lining was fixed in the acetabular prosthesis with the cement and femoral stem was replaced with the Depuy prosthesis.Result:The operative time was about 7 hours,blood loss was about 2 000 ml.Photographs showed that the tumor was resected correctly and the acetabulum was reconstructed well with good function of the hip joint.No nerve injury,deep venous thrombosis,infection,dislocation or other complications were seen.The patient recovered perfect.Conclusion:The computer 3D reconstruction might play a positive role on acetabular tumor resection,matching personal prosthesis designing and pelvic reconstructing perfectly.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2005年第7期518-520,共3页
Orthopedic Journal of China
关键词
髋臼
恶性肿瘤
三维
切除
重建
Acetabulum
Malignant tumor
Three dimension(3D)
Reconstruction
Resection
