Abstract：Objective To explore a 3D printing model of fracture restoration which can be used in preoperative planning and design for proximal femur fractures. To study the feasibility of clinical application of three-dimensional data correction scheme.Methods An analysis of the 47 patients with proximal femur fracture treated from October 2015 to September 2017 in Department of Orthopaedics of Liyang People's Hospital was conducted. Bilateral femur CT scan was performed in all the cases to obtain DICOM data. Using Mimics 15.0 software, cross sections were created at 5 cm, 10 cm and 15 cm above the knee joint at the bilateral distal femur and marked as DF5, DF10 and DF15. The long and short axles on the left and right sides were measured and compared. If the femur was tilted, the correction data would be used. All the data were collected of the long and short axles on the 3 cross-sections (DF5, DF10 and DF15) of the left and right sides of the distal femur. After the STL files for 3D models were generated by using Mimics 15.0 software, a real-sized 3D model of the proximal femur fracture and a mirror model of the contralateral femur were printed. The preoperative manoeuvre was performed on the mirror 3D printed model. The real operation used the implants preoperatively designed, and compared radiographically with those designed in the preoperative manoeuvre.Results There were significant differences between the short axis of the left and right femoral condyle 5 cm from the intercondylar keel [(28.54±3.51) mm vs. (28.20±3.41) mm, t=3.404, P＜0.01)]. There was no significant difference between the left and right sides in the other groups. The differences between the left and right sides showed no statistically significance in paired samples of LL-LS and RL-RS groups on DF5, DF10 and DF15 cross-sections(all P values＞0.05). All the 47 patients received surgical operation. The postoperative X-ray review showed fine agreement between actual surgery and preoperative design in terms of screw length and accuracy. The deviations were in an allowable range, leading to satisfactory internal fixation.Conclusions Symmetry of the bilateral femur can be judged by the “comparison of long axis and short axis of three equidistant transverse sections” methods. If the deviation is less than 5%, the preoperative implants would be directly used. It is satisfactory for postoperative radiography validation. “Three-dimensional data correction scheme” expands the “Comparison of long axis and short axis of three equidistant transverse sections” data selection range, which can effectively avoid the data failure because of limb tilt .
张文玺, 刘杰, 王新明, 李栋, 王帅. 基于三维打印及三维数据校正的骨折复原技术在股骨近端骨折治疗中的应用[J]. 中华解剖与临床杂志, 2018, 23(4): 298-305.
Zhang Wenxi, Liu Jie,Wang Xinming, Li Dong, Wang Shuai.. The application of fracture recovery techniques based on 3D printing and three-dimensional data correction scheme in fractures of the proximal femur. Chinese Journal of Anatomy and Clinics, 2018, 23(4): 298-305.
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2018, Vol. 23 
