Application Of Computer-Aided Design-Rapid Prototyping In Proximal Femoral Fracture

BACKGROUNDIn the past few decades, medical imaging is developing very quickly, such as computerized tomography,, magnetic resonance imaging, digital subtraction angiography, with the help of these devices three-dimensional anatomy of the human body of information were compressed into a two-dimensional image, provides an important basis for disease diagnosis, lesion-point positioning and surgical program. Improved the quality of operation and the safety of surgery. Although the imaging as positive role in the development of orthopedic promoting, but it provides information that does not fully meet the needs of development of orthopedic surgery. In recent years, with the development of computer graphics, imaging science, and computer graphics processing speed of the rapidly increasing, people study from two-dimensional image to three-dimensional image reconstruction technique. With the computer-assisted human rapid bone modeling and rapid manufacturing equipment, allowing doctors in the complex prior to orthopedic surgery may be based on patient's CT images "tailor-made" out of the human body specimens.With the guidance of model, surgery can be fully carried out prior to in vitro simulation, to design the best operative approach and steps to enable the surgical risks are effectively controlled.Development of computer-aided design (CAD)-rapid prototyping implements planar image to three-dimensional solid digitization, thus, provides guidance for disease diagnosis, focus location, and operation project confirmation, which significantly enhance the security and quality of operation.ObjectiveTo evaluate the therapeutic effect of CAD-Rapid Prototyping on treating femoral intertrochanteric fracture.MethodsA total of 30 cases of intertrochanteric fracture, aged 18-55 years, were selected from Department of Orthopaedics, General Hospital of Guangzhou Command (2008.1.1-2008.12.31). Falls in 8 cases, car accidents 12 cases, fall injury in 7 cases, training injury in 3 cases,20 males and 10 females,19 cases of intertrochanteric fracture of the left side, right side of 11 cases of intertrochanteric fracture; 30 patients were randomly divided into two groups, conventional surgery group (n= 15), only routine preoperative tibial tubercle traction; Computer-aided group (n= 15), computer-aided preoperative tibial tubercle traction first and then spiral CT scan and the data derived from patients with intertrochanteric fractures carved CD-ROM, Dell workstation using mimics10.0 software to reconstruct the intertrochanteric fracture model. And the simulation of intertrochanteric fracture reduction surgery, computer-aided design software reverse is consistent with the greater trochanter of the components and set screw casing, computer designed precision screw patch surgery.Preoperative STL format designed to will be keep a USB flash disk placed AFS Laser Rapid Prototyping Machine print physical models, preoperative use of printed model simulation exercises, ensure operative surgical planning and taken to the operating room sterile disinfect in surgery. patients were under epidural anesthesia placed orthopedic traction bed during Surgery, C-arm mechanical and electrical penetration see a good reduction of the fracture before surgery, all patients in two groups were using dynamic hip screw fixation, all recorded operative time (mean operative time from skin incision to closure of the wound), all recorded blood loss,30 patients were followed up for 12 months and using Harris hip score standards, evaluated the results of operations.ResultsComputer-Aided Design-Rapid Prototyping of intertrochanteric fractures of the establishment of the 1:1 physical model and accurate design of the set screw-driven template, Rapid--prototyping technology print a good model in orthopedic surgery, accurately guiding surgical quickly and accurately implementation, greatly enhanced the safety of operation, compared with the conventional surgical group shortened operative time, reduced operative blood loss, avoid the repeated intraoperative C-arm machine perspective, particularly for some elderly patients with more significantlly. After the operation reviewing X-rays see the good fracture reduction, the metal fixation in good position, all patients were followed up after twelve months, application of Harris hip score standards in patients with good recovery and no hip varus deformity and limb shortening deformities, significantly improve the effectiveness of the surgery, all patients reached the pre-expected results.ConclusionTraditional surgery depends on doctors with clinical experience of individual surgical skills, that lack of accuracy, and larger trauma, during surgery both doctors and patients need repeated radiation exposure and other shortcomings and so on.Surgery using a computer program instead of doctors three-dimensional ideas are more objective, quantitative, and its information available for the entire surgical team members to share. If the introduction of three-dimensional images of specific images can communicate with their peers, with computer-assisted human bone modeling and rapid-prototyping manufacturing equipment, allowing doctors in the complex orthopedic surgery can be fully carried out prior to in vitro simulation, to design the best route and steps according to the guidance physical model from patient's CT images; then surgical risks can be effectively controlled Using computer digital medical imaging on high-speed processing and control capabilities, through virtual surgical environment for the orthopedic surgeon from the technical support, to make surgery a more minimally invasive, safer, more accurate a new technology. Computer-aided design-the development of rapid prototyping technology to make the transformation from two-dimensional images into three-dimensional model of leap, for clinicians to disease diagnosis, lesion location point of the surgery to determine the program provides an important basis for making the safety of operation and the quality of surgery has been markedly improved. Computer-Aided Design-Rapid Prototyping technology in surgery is safe, and accurate, preoperative image acquisition intraoperative repeated use, and reduce the radiation damage doctor-patient surgery.