Digital Medicine Technology-aided Surgery For The Reconstruction Of Thumb And Finger Partial Defects

Objective: To investigate the Clinical application of digital medicinetechnology-aided surgery for the reconstruction of thumb and fingerpartial defects.So that we can achieve the normalized, personalized,accurate reconstruction of thumb and finger defects.Method: There were33in-patient cases with43different thumb andfinger partial defect in our orthopedic department. Before operation, usethe64slice dual source spiral CT to obtain the original DICOM data ofthe patient’s injured finger, the same corresponding contralateral fingerand the toe of donor site. And then input the original DICOM data toMimics10.013D reconstruction software to obtain highquality3D model and image of individual donor site and recipient site(including blood, bone, soft tissue) for thumb and finger defectsreconstruction operation based on different patients,we can get acomprehensive understanding of the bone, blood vessels and soft tissue ofdonor site and recipient site. Moreover,we can reconstructthe model of actual defect and injury of thumb and finger, throughMakerBot Replicator23D printer, print out the injured finger and the toe or tissue that is used for the repair, create the model for the transplant orrepair procedure. According the CT Angiography result of the donortissue blood supply,we can deal with the specific and individual conditionof the patient and also obtain precise pre-operation design and standardbefore and during the operation. Reconstruction method:Digital medicalgroup19refers to the first toe nail skin flap transplantation to repair,1refers to fibula side toe abdominal skin flap transplantation to repair;21refers to the second toe tibia lateral nail flap transplantation to repair,2refers to the second toe abdominal skin flap transplantation to repair;Thetraditional surgery group18refers to the first toe nail skin flaptransplantation to repair,1refers to fibula side toe abdominal skin flaptransplantation to repair;20refers to the second toe tibia lateral nail flaptransplantation to repair,2refers to the second toe abdominal skin flaptransplantation to repair.Operation time:18cases of emergency, theemergency operation in11cases,4cases of elective surgical procedures.Record operation time required for a single thumb or fingerreconstructing and intraoperative blood loss.Guide the postoperativepatients with functional exercise,compared with the traditional thumb andfinger defect reconstruction method.The assessment Of the reconstructedthumb and fingers is following The Chinese Medical Association of HandSurgery Society of upper limb functional assessment standard and visualgrading of Hand Surgery Society of Chinese Medical Associationreplantation functional assessment standard.Results: In the digital medical technology group, all of33cases with43fingers survived,reconstruction and repairing a single thumb or fingeroperation time was123.1+/-20.4min, intraoperative blood loss was 256.3+/-51.2ml;In the traditional surgical group, all of32cases with41fingers survived, reconstruction and repair a single thumb or fingeroperation time was180.3+/-31.2min, intraoperative blood loss was342.1+/-61.3ml.Comparing with traditional surgical group, digitalmedical technology aided thumb and finger part defect reconstructionused shorter operation time,and less intraoperative blood loss, thedifference was statistically significant (P <0.05). Digital medical group30cases with40fingers were followed up for3to12months,3cases of3fingers to the loss of follow-up;the traditional surgery group29caseswith37fingers were followed up for3to12months,3cases of4fingersto the loss of follow-up;Comparing with traditional surgery group, thedigital medical group of reconstructing thumb finger function was nostatistically significant difference (P>0.05), digital medical technologyauxiliary part defect reconstruction thumb finger appearance was higher,the difference was statistically significant (P <0.05).Conclusion:1. Through digital medical technology,we can obtain thehigh quality3d model and image of individualized thumb or fingersbased on the reconstructive surgery for patients,we can designpreoperative personalized surgical plan, can avoid blindness operation,reduce the operation risk, reduce the damage for area, shorten theoperation time, Digital medical technology aided surgery of the thumband fingers reconstruction can provide a method of standardization,individuation, accurate for thumb and finger partial defects reconstruction.2. Preoperative virtual surgery, procedural, standardized and pictorialpreoperative design and simulation operation, combined with the actualoperation, convenient to teaching, technical promotion and doctor-patient communication.