| Background:3D printing technology (Three Dimensional Printing,3DP) also known as 3D printing technology is a rapid prototyping technology (Rapid,Prototyping, RP) of a foreign, also known as additive manufacturing technology (Additive, Manufacturing, AM). "Is a traditional material removal process on the contrary, the three-dimensional digital model based on layer by layer, usually by manufacturing process of material combination". Because the very fit with the popular concept of "3D", people for the technology plays a more popular name- "3D print", two said the same concept.In 2010, Obama became the president of the America second years, through the "manufacturing" to stimulate regeneration of bill. America Manufacturing innovation and growth, increase exports. At that time, the impact of the global financial crisis, USA manufacturing industry in the gross domestic product (Gross Domestic, Product, GDP)accounted for only 12%, but the total amount of USA exports 50%. In 2012, Obama announced that*revive America manufacturing plan", the establishment of "national manufacturing innovation network" (The National Network for Manufacturing Innovation, NNMI).The network consists of 15 regional manufacturing Innovation Institute,aims to"government-Enterprise-University" cooperation, strengthen innovation in manufacturing and global manufacturing competitiveness American,3D printing as a priority category. The Clinton government in 1993 and the "information superhighway" by different approaches but equally satisfactory results, which USA come out on top in the field of Internet information technology today. Now, USA "return of manufacturing strategy" on China’s labor intensive industry poses a serious threat to the transformation, it also disguised forced China’s manufacturing industry to the knowledge intensive industry,medical 3D printing is a technology of "Sino US strategic competition". Therefore, has important strategic significance to the research in this field, brook no delay.The technology originated in twentieth Century 80 at the end of the 1970s, but the real into the rapid development stage was around 2010, China from the last century 90’s to introduce this technology.2012, known as the "3D printing the first year", was a turning point in the 3D printing market from germination stage to enter the growth stage, is a landmark event in the USA with Israel Stratasys Objet two 3D printing company announced the merger, the 3D printing technology to achieve the initial industrialization in America. In 2012 April, the British "economist" magazine feature production, discusses the industrial areas in the world are experiencing the third revolution, the revolution that is established on the Internet and new materials, new energy, the combination of the industrial revolution, with its "Digital Manufacturing" as the core, and the allocation of factors the global technology and market factors of revolutionary change.3D printing technology as an important symbol of "" the third industrial revolution, is considered to be an important opportunity to promote a new round of industrial revolution, has caused widespread concern in the world. As a new technology is advanced, the pilot,3D printing technology is the traditional mode of production and production process of profound change.3D printing technology with its revolutionary "flexibility" and"save the raw material in manufacturing" set off a revolution. It is the most suitable for application in the structure of the multi variety and small batch, morphology, complex structure, high manufacturing raw material value, so it is widely used in medical field. In 2013 February, America (Massachusetts Institute of Technology Massachusetts Institute of Technology, MIT) thinking Keller Tibitz announced 4D printing technology, the technology of direct programming characters want through print materials, and then print out the object of "automatic", does not need any complex electro mechanical equipment. The news came out, the entire industry was boiling, along with related high-tech materials stocks also have soared.The exoskeleton a word comes from biology, refers to the hard outer structure protection and support for the biological. Exoskeleton system such as crustaceans and insects and other arthropod animal, and is very similar to traditional small splint external fixation mechanism. USA in 2000 to carry out "to enhance the function of the body of the exoskeleton" (Exoskeletons for Human Performance Augmentation, EHPA) research project, since then, the development and application of the exoskeleton device gradually into people’s attention, and has become the focus of attention. The skeletal system provides functions such as protection, physical support to patients, can help patients to complete the limb function of certain activities, so the medical application of auxiliary function in the process of exercise in patients with limb dysfunction gradually.Traditional Chinese medicine splint external fixation fracture treatment has Chinese characteristics, from the "combination", "bones" point of view, the clever use of bio mechanical splint elastic pad pressure, the fracture reduction, fixation and functional exercise are organically combined together, make the fracture healing and functional recovery the good effect do many things at once. But the traditional plywood production standards are not unified, material limitations (willow bark of Taxus, etc.), the appearance of rough, not the original green, manufacturing is in manual operation, apply the drug to stimulate the skin, causing difficulties for learning and promote the application of this technology. At present, people cut down the trees are becoming more and more serious, the "green lung" of the world known as the forest area decreased, the deterioration of air quality, from the point of view of forest protection, the protection of mother nature, it is necessary for the development of new alternative materials, organic can be recycled.If the Chinese medicine small splint external fixation device, the use of computer aided design virtual digital modeling, and the small splint of the internal structure and appearance design, the computer finite element analysis of material in the virtual stress (Finite Element Analysis, FEA), the band and the pressure pad for bio mechanical virtual test; small splint external fixation of various parameters of operation, location, operation procedures, standardization, standardization, quantitative analysis, final ly use 3D to print the way making out, and clinical trials. This digital 3DP and small splint is very easy to learn and to promote the application of difference between the treatment effect, can be with other therapy to get the correct evaluation, treatment effect is more capable of being recognized by the industry. Research on digital and quantitative splint can also learn the material parameters of bio mechanics and definition of external fixation for the treatment of the new alternative materials, to find the better (and even add ingredients), let the external fixation can achieve the purpose of treatment, to avoid damage caused by improper external fixation, to improve the safety of external fixation for the treatment of the fractureThis research adopts the research methods of analysis and bio mechanical test of computer virtual modeling, finite element, the Coll.es fractures after manipulative reduction with the parameters of four super wrist fixing splint for measurement and quantitative analysis of traditional Chinese medicine, the traditional small splint technology of digital modeling and quantitative, and explore the new 3DP splint external morphology, internal structure, material selection, band device, pressure pad design, build 3DP small splint bones from software to hardware complete system, make efforts for innovation application of 3D printing technology in the medical device industry in external fixation. Objective1. In 30 cases of Colles patients with fracture of limb, mechanical parameters of the same operator implementation after manual reduction in the four splints super wrist fixed traditional fir bark splint for the measurement and statistical analysis of patient related parameters related.2. In 45 cases of Colles patients with fracture of limb, mechanical parameters of different operators to implement after manual reduction splint four super wrist fixed traditional fir bark splint for the measurement and statistical analysis of patient related parameters related.3. According to the image data obtained by CT scanning, computer three-dimens i onal modeling software Solidworks 2012 to establish the conventional virtual digital small splint model, finite element analysis is carried out using the Ansys9.0 software, and then the digital plates internal structure and shape optimization of exoskeleton.4. Selection of nylon fiber glass, the application of the German EOS 3D printer manufacturing digital plates.5. According to the bio mechanics of small splint parameter determination, using computer modeling method of Solidworks software for digital 3DP and small splint for finite element analysis of the bio mechanics of fracture site, understand the new small splint external fixation for fracture treatment mechanism.6. According to the research data, the development of 3D printing digital small splint database application software platform, the simplified modeling, easy to share, improve efficiency. Methods1. The same operator of traditional small splint immobilization study of parameters andoperating characteristics and influencing factors in measurement, physical. Methods using vernier caliper, ruler, tape measure, were measured in 30 cases of Colles fractures in patients with limb wrist circumference, thin film pressure sensor using Tekscan multi-channel single point force acquisition system, measurement of traditional small splint distaldorsal plate pressure pad under pressure (referred to as:dorsal lateral pressure), the traditional small splint distal palmar side pressure pad under pressure (referred to as:volarstress), and the data of 30 patients were collected and statistical analysis. The collection and analysis of factors, may affect the operation of the small splints:gender, age, weight, body mass index, height, diameter, patient health wrist wrist circumference, the affected wrist swelling degree (the healthy limb circumference difference), injury time.2. Different operators of traditional small splint immobilization study of parameters and operation characteristics and influence factors of measurement, in the physical strength. Using vernier calipers, ruler, tape measure, were measured in 45 cases of Colles fractures in patients with limb wrist circumference, thin film pressure sensor using Tekscan multi-channel single point force acquisition system, measurement of traditional small splint distal dorsal plate pressure pad under pressure (referred to as:dorsal lateral pressure), the traditional small splint distal palmar side pressure pad under pressure (referred to as:volar stress), and the data of 45 patients were collected and statistical analysis. The collection and analysis of factors, may affect the operation of the small splints:gender, age, weight,body mass index, height, diameter, patient health wrist wrist circumference, the affected wrist swelling degree (the healthy limb circumference difference), injury time.3. Limb three-dimensional virtual and physical modeling:a total of 1 cases of the Colles fracture patients, informed consent of the affected arm CT scans were obtained after section, the two-dimensional image, image segmentation,3D reconstruction, saved as STL format. The establishment of the affected arm bone and soft tissue file into Maya in the visualization of 3D virtual model. The application of computer assisted laser sinte ring rapid prototyping 1:1 entity model of limb. Take the model as the prototype, the silicone mould technology, produce fracture arm solid silica gel model for practical application, verify the feasibility of the new 3D print small splint.4. Computer modeling of a novel 3D print small splint:Modeling for 1 young male volunteers, after examination, identified as Colles fold, the use of spiral CT, with lmm interval, along the axial scan, save, into three-dimensional reconstruction software Mimics, tissue cutting, bone, skin, muscle to obtain 3D model, preservation the establishment of three-dimensional model of the arm fracture, the fracture is imported into Solidworks software, three-dimensional model and virtual cutting of manipulative reduction after the success of the fracture line."". Accordingly, small splint external skeletal figure modeling model 3DP fracture. According to the clinical data of 30 cases of patients with the results of the analysis, the 3D digital model of traditional small splint in SketchUp software.5. Using the German EOS 3D printer to print the optimized 3DP exoskeleton.6. Finite element analysis:the establishment of the mesh and finite element model:will generate the Mimics software under the bone three-dimensional model into Ansys9.0 software, the finite element mesh model. Then after the division of three-dimensional entitymodel into Mimics, according to the corresponding relationship between bone CT image gray and the elastic modulus of bone cell, material properties are given, and then back to the Ansys9.0 software. The three-dimensional digital model of the traditional small splint is established in SketchUp software, and the optimized 3DP small splint bone three-dimensional digital model into the Ansys9.0 software, the finite element mesh. After the above steps, respectively, the establishment of three-dimensional finite element model of 1 traditional small splint external fixation of Colles fracture, and 13DP and small splint external skeletal fixation of Colles fracture three-dimensional finite element model. This study is not to consider the contact load under the broken end of the fracture, so the load loading mode to join the splint model fracture ends connected into a whole (relative displacement does not occur), but did not join the "fracture of three-dimensional model of"two fracture gap, the fracture ends were no contact, no torsional displacement or not to make the pressure load, plate fracture torsion load and three point bending load size for reference. Simulation of dynamic effects of not considering all the computer, turn not to consider the angular velocity, static loading test. Solution and calculation:in the Ansys9.0 software, using the finite element solver in loading conditions "fracture" node stress value,understanding the treatment mechanism of small splint, and the skeleton of 3DP small splint external reverse optimization).7. The use of Visual FoxPro programming software is written "3DP small splint external skeletal system operation platform" software, can be a good user interface, at any time to extract the necessary "3DP small splint bones" data, and can instantly print by 3D. ResultsAll the fractures were the traditional small splint external fixation for the treatment, no negative damage.1. During the operation, the stress fractures of distal fractures of the distal radius, the traditional small splint distal dorsal plate pressure (referred to as:dorsal lateral pressure), proximal volar stress for the traditional small splint distal volar plate pressure block fracture distal radius fractures (referred to as:volar stress). The traditional small splint distal dorsal plate pressure minimum value is:37.65N, the maximum value is:106.76N, average:76.09 ±21. 11N; distal volar plate pressure is the minimum value is 127.59N, the maximum was 372.39N, mean 226.10± 64. 10N.2. By Pearson correlation analysis, the traditional splint distal palm peak and mean pressure plate R=0.862, P=0.000, the traditional small splint distal dorsal side pressure peak and mean value of R=0.968, P=0.000 showed that there is a significant correlation between the two sets of parameters; small splint distal palmar side pressure peak and small splint distal dorsal side of the peak pressure R=0.510 P=0.052, have certain correlation;small splint distal volar plate pressure mean and small splint distal dorsal plate pressure mean value of P=0.096, no significant correlation;3. Through the analysis of multiple linear regression, there was a significant correlation between the dorsal splint pressure peak and the patient’s age and body mass index, and negatively correlated with age, and was positively correlated with body mass index. The regression equation is:the dorsal splint pressure peak of=97.094-0.502* age of dorsal splint pressure peak age body mass index=52.684-0.437*+1.892*. The regression equation of standard:the dorsal splint pressure peak value=-0.543* age the dorsal splint pressure peak age body mass index=-0.472*+0.350*.4. There was a significant correlation between the peak age of lateral pressure and small splint palmar, was negatively correlated with age. The multiple linear regression equation:small splint palmar peak pressure =150.139-0.830* age. The regression equation ofstandard:small splint palmar peak pressure =-0.677* age.he rank sum test, male, female groups in operation time, fixed splint palmar peak pressure, there was no significant difference between the dorsal peak. 5. The establishment of a new three-dimensional virtual models of fracture splint, and finite element analysis.Conclusion1.The operator of the traditional small splint distal dorsal plate during the operation, the peak pressure is increased, the peak pressure of the distal palmar side board is greater;2. The age of the patients of distal dorsal plate pressure, palm size distal pressure side effects as follows:the older, the distal dorsal plate pressure and distal volar plate pressure is small; the BMI effect of distal volar plate pressure on the back plate of distal pressure, as follows:the greater the body mass index, dorsal plate of distal, distal volar plate pressure the greater the pressure.3. The use of three-dimensional modeling software, computer modeling methods of the digital3DP and small splint for finite element analysis of the bio mechanics of fracture site, understand the mechanism of treatment of fracture fixation.4. Combined with computer graphics,3D animation technology, sensor technology, reverse engineering technology and silica gel mould technology, established the 3D virtual mode land solid silica gel model fracture of the arm, the 3D model of small splint to restore the whole process of printing real from virtual to reality. |
PDF Full Text Request