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CN114271920B - A preparation method for 3D printing combined guide plate suitable for femoral neck system - Google Patents

A preparation method for 3D printing combined guide plate suitable for femoral neck system
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CN114271920B
CN114271920BCN202210003999.XACN202210003999ACN114271920BCN 114271920 BCN114271920 BCN 114271920BCN 202210003999 ACN202210003999 ACN 202210003999ACN 114271920 BCN114271920 BCN 114271920B
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bone
nail
femoral neck
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盛晓磊
葛建飞
刘苏
田守进
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Suzhou Kangli Orthopaedics Instrument Co ltd
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ZHANGJIAGANG FIRST PEOPLE'S HOSPITAL
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Abstract

The invention relates to a preparation method of a 3D printing combined guide plate suitable for a femoral neck system, which comprises two parts of fracture three-dimensional CT data acquisition and guide plate design, wherein the guide plate design comprises a central guide pin guide hole design, an anti-rotation guide pin guide hole design, a small tuberosity positioning and fixing guide hole design and a detachable fixing base design.

Description

Translated fromChinese
一种适用于股骨颈系统3D打印组合式导板制备方法A preparation method for 3D printing combined guide plate suitable for femoral neck system

技术领域Technical field

本发明涉及一种3D打印组合式导板制备方法,具体是一种适用于股骨颈系统3D打印组合式导板制备方法。The invention relates to a 3D printing combined guide plate preparation method, specifically a 3D printing combined guide plate preparation method suitable for femoral neck systems.

背景技术Background technique

股骨颈骨折常见于老年患者,占全身部骨折的3.6%。随着交通的快速发展,高能量损伤导致年轻人股骨颈骨折发生率增高,髋关节活动不良、股骨头缺血坏死和骨折不愈合等并发症仍是目前治疗的难点。内固定物包括空心钉、动力髋螺钉、锁定钢板及髓内钉等。但是文献报道内固定术后的失败率高达37%,3枚空心钉固定是治疗股骨颈骨折的“金标准”,但是螺钉退出、切割、松动却很常见,且空心钉固定强度低,患者术后仍需长期卧床;动力髋螺钉适用于剪切型骨折,但存在创伤较大,股骨颈内骨质丢失较多,单枚螺钉的抗旋力弱等不足。Femoral neck fractures are common in elderly patients, accounting for 3.6% of all fractures. With the rapid development of transportation, high-energy injuries have led to an increase in the incidence of femoral neck fractures in young people. Complications such as hip joint dysfunction, avascular necrosis of the femoral head, and fracture nonunion are still difficult to treat. Internal fixation includes cannulated nails, dynamic hip screws, locking plates, intramedullary nails, etc. However, literature reports that the failure rate after internal fixation is as high as 37%. Fixation with three cannulated screws is the "gold standard" for the treatment of femoral neck fractures. However, withdrawal, cutting, and loosening of screws are common, and the fixation strength of cannulated screws is low. After surgery, patients still need to stay in bed for a long time; dynamic hip screws are suitable for shear fractures, but they have disadvantages such as greater trauma, more bone loss in the femoral neck, and weak anti-rotation force of a single screw.

瑞士髋关节研究小组历经10年研发了一种固定股骨颈骨折的新武器“股骨颈动力抗旋交叉钉系统(Femoral Neck System,FNS)”,其独特的“钉中钉”设计,既能微创置入,又可以提供稳定的抗旋力,而且很少出现螺钉切割、退钉等现象,使患者术后早期负重下地,提高了生活质量,减少了卧床所带来的一系列并发症,为股骨颈骨折内固定治疗提供了新的治疗手段。但是,由于股骨颈解剖特殊,存在前倾角、颈倾角与颈干角,且FNS新技术存在一定的学习曲线,需要术者有丰富的经验和熟练的手术技术,同时需多次透视调整中央定位导针在股骨颈内的合适位置,而导针在股骨颈内反复调整会影响骨质质量,进而影响内固定的稳定性;同时,术中多次透视增加手术时间,增加患者及医护人员射线暴露风险。因此,亟需一种更加安全、高效的方法来保证FNS中央定位导针的精确、安全置入。The Swiss hip joint research team spent 10 years developing a new weapon for fixing femoral neck fractures, the "Femoral Neck Dynamic Anti-rotation Cross Nail System (FNS)". Its unique "nail-in-nail" design can both micro- Intravenous insertion can provide stable anti-rotation force, and rarely occur screw cutting, screw withdrawal, etc., allowing patients to bear weight on the ground in the early postoperative period, improving the quality of life and reducing a series of complications caused by bed rest. It provides a new treatment method for internal fixation of femoral neck fractures. However, due to the special anatomy of the femoral neck, there are anteversion angles, cervical inclination angles and neck-shaft angles, and the new FNS technology has a certain learning curve, which requires the surgeon to have rich experience and skilled surgical techniques, and multiple fluoroscopic adjustments are required to adjust the central positioning. The guide pin is in the appropriate position in the femoral neck. Repeated adjustments of the guide pin in the femoral neck will affect the bone quality and thus the stability of the internal fixation. At the same time, multiple fluoroscopy during the operation will increase the operation time and increase the radiation exposure for the patient and medical staff. exposure risk. Therefore, a safer and more efficient method is urgently needed to ensure the accurate and safe placement of the FNS central positioning guide pin.

近年来,随着3D 打印技术的不断成熟和发展,与临床实践结合的也越来越密切,通过将三维重建技术、逆向工程技术与 3D 打印技术相结合所设计制作的个性化导航模板也越来越多的用于临床辅助骨科内固定技术。3D打印技术是近年来新兴发展和成熟的一种技术,又叫“快速成型技术”,需要进行3D打印的病人,术前进行CT扫描及三维重建,将扫描数据导入到Mimics软件,通过一些特殊的材料打印成3D模型及导航模板,临床医师可以根据实物模型,更加准确地了解骨折的程度,术前可以制定精确、详实的手术方案,通过利于3D打印导航模板辅助手术,提高手术置钉的精确性和安全性,减少患者及医务人员X线透视暴露时间。In recent years, as 3D printing technology continues to mature and develop, it has become more and more closely integrated with clinical practice. Personalized navigation templates designed and produced by combining three-dimensional reconstruction technology, reverse engineering technology and 3D printing technology have become more and more sophisticated. It is increasingly used as clinical auxiliary orthopedic internal fixation technology. 3D printing technology is an emerging and mature technology in recent years. It is also called "rapid prototyping technology". Patients who need 3D printing need to perform CT scans and three-dimensional reconstruction before surgery, and import the scan data into Mimics software. Through some special The materials are printed into 3D models and navigation templates. Clinicians can more accurately understand the extent of fractures based on the physical models, and can formulate precise and detailed surgical plans before surgery. By facilitating the 3D printing of navigation templates to assist surgery, the efficiency of surgical nail placement can be improved. Accuracy and safety, reducing X-ray exposure time for patients and medical staff.

因此,研发一种能够术中安装拆卸便捷、辅助置钉安全有效的导航模板装置及其制备方法是非常有必要的。Therefore, it is very necessary to develop a navigation template device and its preparation method that can be easily installed and disassembled during surgery, and can assist in safe and effective nail placement.

发明内容Contents of the invention

针对上述现有技术存在的问题,本发明提供一种适用于新型股骨颈内固定系统的3D打印组合式导板制备方法,有效的提高置钉的准确性,提高置钉安全性,缩短手术时间,减少患者和医务人员在X线下暴露次数和时间。In view of the problems existing in the above-mentioned prior art, the present invention provides a 3D printing combined guide plate preparation method suitable for the new femoral neck internal fixation system, which can effectively improve the accuracy of screw placement, improve the safety of screw placement, and shorten the operation time. Reduce the number and time of patients and medical staff exposed to X-rays.

为了实现上述目的,本发明通过以下技术方案实现:一种适用于股骨颈系统3D打印组合式导板制备方法,其制备方法分为骨折三维CT数据采集和导板设计两部分组成,其具体制备方法如下:In order to achieve the above objectives, the present invention is implemented through the following technical solutions: a method for preparing a 3D printed combined guide plate suitable for femoral neck systems. The preparation method is divided into two parts: fracture three-dimensional CT data acquisition and guide plate design. The specific preparation method is as follows :

骨折三维CT数据采集Fracture three-dimensional CT data collection

(1)实用三维CT扫描设备将患者患处的骨骼进行扫描;(1) Use three-dimensional CT scanning equipment to scan the patient’s bones in the affected area;

(2)将步骤(1)扫描患者患处的三维CT扫描数据,导入CT扫描数据到三维重建软件(Mimics 21.0);(2) Scan the three-dimensional CT scan data of the patient’s affected area in step (1) and import the CT scan data into the three-dimensional reconstruction software (Mimics 21.0);

(3)对步骤(2)中提取的CT扫描原始数据进行优化处理,将髋关节部分的骨头进行逐层分割,先选择各个骨头的灰度进行分割,分别提取股骨、髋骨等各个骨骼信息,而后以区域增长的方式清理各个骨头之间的杂乱信息;(3) Optimize the original CT scan data extracted in step (2), segment the bones of the hip joint layer by layer, first select the grayscale of each bone for segmentation, and extract the information of each bone such as the femur and hip bone respectively. , and then clean up the messy information between each bone in a region growing manner;

(4)将步骤(3)清理完成后的骨头之间的信息采用系统默认的(optimal)命令把各个骨头根据前面所选取的阈值计算出来。(4) Use the system default (optimal) command to calculate the information between bones after cleaning in step (3) and calculate each bone according to the threshold selected previously.

(5)使用Mimics 21.0 软件中测得股骨颈三维数据,根据测量结果在软件3-Matic中实行预复位;(5) Use the Mimics 21.0 software to measure the three-dimensional data of the femoral neck, and perform pre-reduction in the software 3-Matic based on the measurement results;

(6)将步骤(5)复位后的股骨颈三维数据使用NX10.0软件把骨钉、中央定位导针和模拟骨钻圆柱的相对位置关系绘制出来导出stl格式备用,然后把这个模型和股骨一起导入到Magics21.0中;(6) Use NX10.0 software to draw the relative positional relationship between the bone nail, the central positioning guide pin and the simulated bone drill cylinder using the three-dimensional data of the femoral neck after reduction in step (5), export it to stl format for later use, and then combine this model with the femur Import them into Magics21.0 together;

(7)圆柱体与股骨干夹角设计为130°,转动三维结构中的圆柱体,缓慢拖动滚轴,分别在3D界面、横断面、矢状面、冠状面观察圆柱体通过股骨颈的位置关系,进而完成下FNS的模拟安全钉道设计;(7) The angle between the cylinder and the femoral shaft is designed to be 130°. Rotate the cylinder in the three-dimensional structure, slowly drag the roller, and observe the movement of the cylinder through the femoral neck on the 3D interface, transverse plane, sagittal plane, and coronal plane. position relationship, and then complete the simulated safety nail track design of the lower FNS;

(8)观察模拟安全钉道和骨钉是否穿破股骨颈及股骨头,并根据观察结果对模拟安全钉道和骨钉做适当微调,以确保FNS模拟安全钉道的安全性及准确性;(8) Observe whether the simulated safety nail channels and bone screws penetrate the femoral neck and femoral head, and make appropriate fine adjustments to the simulated safety nail channels and bone screws based on the observation results to ensure the safety and accuracy of the FNS simulated safety nail channels;

导板设计由中央导针导向孔设计、抗旋导针导向孔设计、小粗隆定位固定导向孔设计、可装卸固定基座设计组成,The guide plate design consists of a central guide pin guide hole design, an anti-rotation guide pin guide hole design, a lesser trochanter positioning and fixing guide hole design, and a removable fixed base design.

(9)使用Magics21.0软件中按照模拟安全钉道的轨迹轴心线设定钉道直径,将中央导针导向孔内径设计为3.2 mm,外径为7.5 mm,导针尖部距离软骨下骨5 mm;(9) Use the Magics21.0 software to set the diameter of the nail path according to the trajectory axis of the simulated safe nail path. Design the inner diameter of the central guide pin guide hole to be 3.2 mm and the outer diameter to be 7.5 mm. The distance between the tip of the guide pin and the subchondral bone is 5mm;

抗旋导针导向孔设计Anti-rotation guide pin guide hole design

(10)使用Magics21.0软件中按照模拟安全钉道的轨迹轴心线设定一平行于中央导针的轴心线,两轴心线之间的距离为8 mm,将抗旋导针导向孔内径设计为3.2 mm,外径为7.5 mm,导针尖部距离软骨下骨5 mm;(10) Use the Magics21.0 software to set an axis parallel to the central guide pin according to the trajectory axis line of the simulated safety nail path. The distance between the two axis lines is 8 mm, and guide the anti-rotation guide pin. The inner diameter of the hole is designed to be 3.2 mm, the outer diameter is 7.5 mm, and the distance between the tip of the guide pin and the subchondral bone is 5 mm;

小粗隆定位固定导向孔设计Design of guide holes for positioning and fixation of the lesser trochanter

(11)使用Magics21.0软件中设计一垂直于股骨干,平行于小粗隆下缘的定位固定导向孔,导向孔内径设计为2.1 mm,外径为7.5 mm;(11) Use Magics21.0 software to design a positioning and fixing guide hole perpendicular to the femoral shaft and parallel to the lower edge of the lesser trochanter. The inner diameter of the guide hole is designed to be 2.1 mm and the outer diameter is 7.5 mm;

可装卸固定基座设计Removable fixed base design

(12)使用Geomagic 2019软件中提取股骨大粗隆外侧壁表面解剖数据,将这个表面数据导入到Magics21.0并其做反向偏移2.0 mm处理,将偏移表面和原始表面合并、填充和优化,建立与股骨大粗隆外侧壁解剖形态一致的方向基座,基座上缘与股外侧肌嵴平行(上缘宽2 cm),基座下缘与小粗隆下缘平行(下缘宽3 cm);(12) Use Geomagic 2019 software to extract the anatomical surface data of the lateral wall of the greater trochanter of the femur. Import this surface data into Magics21.0 and perform reverse offset processing of 2.0 mm. Merge, fill and Optimize and establish a directional base consistent with the anatomical shape of the lateral wall of the greater trochanter of the femur. The upper edge of the base is parallel to the vastus lateralis muscle crest (the upper edge is 2 cm wide), and the lower edge of the base is parallel to the lower edge of the lesser trochanter (the lower edge Width 3 cm);

(13)将步骤(12)的基座同时导入三个导向孔数据,两者组合重建导向模板雏形,形成定位导向孔的FNS的导航模板,根据导向孔的位置把导板一分为二,使其分割线基本都在导向孔最大分开处,生成上下2个组合式导板;(13) Import the three guide hole data into the base from step (12) at the same time. The two are combined to reconstruct the prototype of the guide template to form the FNS navigation template for positioning the guide holes. The guide plate is divided into two according to the position of the guide holes, so that The dividing line is basically at the maximum separation of the guide holes, generating two combined guide plates, upper and lower;

(14)将步骤(13)生成上下2个组合式导板运用布尔运算后,贯通导向模板钉道,并对边界进行修整,完成组合式导板的设计;(14) Apply Boolean operations to the upper and lower combined guide plates generated in step (13), penetrate the guide template nail path, and trim the boundaries to complete the design of the combined guide plate;

(15)在步骤(14)的导板基础上使用NX10.0软件中设计3个内径为7.6 mm外径为8.5mm高为5mm的圆环;(15) Based on the guide plate in step (14), use NX10.0 software to design three rings with an inner diameter of 7.6 mm, an outer diameter of 8.5mm, and a height of 5mm;

(16)将步骤(15)设计好的导板输入到SL 450三维立体打印方式成型机进行打印制作;(16) Input the guide plate designed in step (15) into the SL 450 three-dimensional printing molding machine for printing;

(17)将步骤(16)打印好的导板采用低温等离子灭菌。(17) Use low-temperature plasma to sterilize the guide plate printed in step (16).

借由上述方案,本发明至少具有以下优点:临床医师可以根据实物模型,更加准确地了解骨折的程度,术前可以制定精确、详实的手术方案,不需要术者有丰富的经验和熟练的手术技术,无需多次透视调整中央定位导针在股骨颈内的合适位置,导针在股骨颈内不需要反复调整,杜绝出现影响骨质质量情况的发生,提高手术置钉的精确性和安全性,无需术中多次透视增加手术时间,大大减少患者及医护人员射线暴露风险,本发明制作成本低,适合大范围的推广和使用。Through the above solution, the present invention at least has the following advantages: clinicians can more accurately understand the degree of fracture based on the physical model, and can formulate precise and detailed surgical plans before surgery, without requiring the surgeon to have extensive experience and skill in surgery. Technology eliminates the need for multiple fluoroscopic adjustments to the appropriate position of the central positioning guide pin in the femoral neck. The guide pin does not need to be repeatedly adjusted in the femoral neck, eliminating the occurrence of conditions that affect bone quality and improving the accuracy and safety of surgical nail placement. , there is no need for multiple fluoroscopy during the operation to increase the operation time, and the risk of radiation exposure of patients and medical staff is greatly reduced. The production cost of the invention is low, and it is suitable for wide-scale promotion and use.

具体实施方式Detailed ways

下面对本发明作进一步说明。The present invention will be further described below.

本适用于股骨颈系统3D打印组合式导板制备方法,其制备方法分为三维CT数据采集和导板设计两部分组成,其具体制备方法如下:This method is suitable for the preparation of 3D printed combined guide plates for femoral neck systems. The preparation method is divided into two parts: three-dimensional CT data acquisition and guide plate design. The specific preparation methods are as follows:

骨折三维CT数据采集Fracture three-dimensional CT data collection

(1)实用扫描三维CT设备将患者患处的骨骼进行扫描;(1) Use scanning three-dimensional CT equipment to scan the patient’s bones in the affected area;

(2)将步骤(1)扫描患者患处的三维CT扫描数据,导入CT扫描数据到三维重建软件(Mimics 21.0);(2) Scan the three-dimensional CT scan data of the patient’s affected area in step (1) and import the CT scan data into the three-dimensional reconstruction software (Mimics 21.0);

(3)对步骤(2)中提取的CT扫描原始数据进行优化处理,将髋关节部分的骨头进行逐层分割,先选择各个骨头的灰度进行分割,分别提取股骨、髋骨等各个骨骼信息,而后以区域增长的方式清理各个骨头之间的杂乱信息;(3) Optimize the original CT scan data extracted in step (2), segment the bones of the hip joint layer by layer, first select the grayscale of each bone for segmentation, and extract the information of each bone such as the femur and hip bone respectively. , and then clean up the messy information between each bone in a region growing manner;

(4)将步骤(3)清理完成后的骨头之间的信息采用系统默认的(optimal)命令把各个骨头根据前面所选取的阈值计算出来;这样就得到完整的骨头,然后在对骨头表面进行修复,最后以STL格式进行储存备用;(4) Use the system default (optimal) command to calculate the information between the bones after cleaning in step (3) to calculate each bone according to the previously selected threshold; in this way, complete bones are obtained, and then the bone surface is Repair, and finally save in STL format for later use;

(5)使用Mimics 21.0 软件中测得股骨颈三维数据,根据测量结果在软件3-Matic中实行预复位;(5) Use the Mimics 21.0 software to measure the three-dimensional data of the femoral neck, and perform pre-reduction in the software 3-Matic based on the measurement results;

(6)将步骤(5)复位后的股骨颈三维数据使用NX10.0软件把骨钉、中央定位导针和模拟骨钻圆柱的相对位置关系绘制出来导出stl格式备用,然后把这个模型和股骨一起导入到Magics21.0中;(6) Use NX10.0 software to draw the relative positional relationship between the bone nail, the central positioning guide pin and the simulated bone drill cylinder using the three-dimensional data of the femoral neck after reduction in step (5), export it to stl format for later use, and then combine this model with the femur Import them into Magics21.0 together;

(7)圆柱体与股骨干夹角设计为130°,转动三维结构中的圆柱体,缓慢拖动滚轴,分别在3D界面、横断面、矢状面、冠状面观察圆柱体通过股骨颈的位置关系,进而完成下FNS的模拟安全钉道设计;(7) The angle between the cylinder and the femoral shaft is designed to be 130°. Rotate the cylinder in the three-dimensional structure, slowly drag the roller, and observe the movement of the cylinder through the femoral neck on the 3D interface, transverse plane, sagittal plane, and coronal plane. position relationship, and then complete the simulated safety nail track design of the lower FNS;

(8)观察模拟安全钉道和骨钉是否穿破股骨颈及股骨头,并根据观察结果对模拟安全钉道和骨钉做适当微调,以确保FNS模拟安全钉道的安全性及准确性;(8) Observe whether the simulated safety nail channels and bone screws penetrate the femoral neck and femoral head, and make appropriate fine adjustments to the simulated safety nail channels and bone screws based on the observation results to ensure the safety and accuracy of the FNS simulated safety nail channels;

导板设计由中央导针导向孔设计、抗旋导针导向孔设计、小粗隆定位固定导向孔设计、可装卸固定基座设计组成,The guide plate design consists of a central guide pin guide hole design, an anti-rotation guide pin guide hole design, a lesser trochanter positioning and fixing guide hole design, and a removable fixed base design.

(9)使用Magics21.0软件中按照模拟安全钉道的轨迹轴心线设定钉道直径,将中央导针导向孔内径设计为3.2 mm,外径为7.5 mm,导针尖部距离软骨下骨5 mm;(9) Use the Magics21.0 software to set the diameter of the nail path according to the trajectory axis of the simulated safe nail path. Design the inner diameter of the central guide pin guide hole to be 3.2 mm and the outer diameter to be 7.5 mm. The distance between the tip of the guide pin and the subchondral bone is 5mm;

抗旋导针导向孔设计Anti-rotation guide pin guide hole design

(10)使用Magics21.0软件中按照模拟安全钉道的轨迹轴心线设定一平行于中央导针的轴心线,两轴心线之间的距离为8 mm,将抗旋导针导向孔内径设计为3.2 mm,外径为7.5 mm,导针尖部距离软骨下骨5 mm;(10) Use the Magics21.0 software to set an axis parallel to the central guide pin according to the trajectory axis line of the simulated safety nail path. The distance between the two axis lines is 8 mm, and guide the anti-rotation guide pin. The inner diameter of the hole is designed to be 3.2 mm, the outer diameter is 7.5 mm, and the distance between the tip of the guide pin and the subchondral bone is 5 mm;

小粗隆定位固定导向孔设计Design of guide holes for positioning and fixation of the lesser trochanter

(11)使用Magics21.0软件中设计一垂直于股骨干,平行于小粗隆下缘的定位固定导向孔,导向孔内径设计为2.1 mm,外径为7.5 mm;(11) Use Magics21.0 software to design a positioning and fixing guide hole perpendicular to the femoral shaft and parallel to the lower edge of the lesser trochanter. The inner diameter of the guide hole is designed to be 2.1 mm and the outer diameter is 7.5 mm;

可装卸固定基座设计Removable fixed base design

(12)使用Geomagic 2019软件中提取股骨大粗隆外侧壁表面解剖数据,将这个表面数据导入到Magics21.0并其做反向偏移2.0 mm处理,将偏移表面和原始表面合并、填充和优化,建立与股骨大粗隆外侧壁解剖形态一致的方向基座,基座上缘与股外侧肌嵴平行(上缘宽2 cm),基座下缘与小粗隆下缘平行(下缘宽3 cm);(12) Use Geomagic 2019 software to extract the anatomical surface data of the lateral wall of the greater trochanter of the femur. Import this surface data into Magics21.0 and perform reverse offset processing of 2.0 mm. Merge, fill and Optimize and establish a directional base consistent with the anatomical shape of the lateral wall of the greater trochanter of the femur. The upper edge of the base is parallel to the vastus lateralis muscle crest (the upper edge is 2 cm wide), and the lower edge of the base is parallel to the lower edge of the lesser trochanter (the lower edge Width 3 cm);

(13)将步骤(12)的基座同时导入三个导向孔数据,两者组合重建导向模板雏形,形成定位导向孔的FNS的导航模板,根据导向孔的位置把导板一分为二,使其分割线基本都在导向孔最大分开处,生成上下2个组合式导板;(13) Import the three guide hole data into the base from step (12) at the same time. The two are combined to reconstruct the prototype of the guide template to form the FNS navigation template for positioning the guide holes. The guide plate is divided into two according to the position of the guide holes, so that The dividing line is basically at the maximum separation of the guide holes, generating two combined guide plates, upper and lower;

(14)将步骤(13)生成上下2个组合式导板运用布尔运算后,贯通导向模板钉道,并对边界进行修整,完成组合式导板的设计;(14) Apply Boolean operations to the upper and lower combined guide plates generated in step (13), penetrate the guide template nail path, and trim the boundaries to complete the design of the combined guide plate;

(15)在步骤(14)的导板基础上使用NX10.0软件中设计3个内径为7.6 mm外径为8.5mm高为5mm的圆环;(15) Based on the guide plate in step (14), use NX10.0 software to design three rings with an inner diameter of 7.6 mm, an outer diameter of 8.5mm, and a height of 5mm;

(16)将步骤(15)设计好的导板输入到SL 450三维立体打印方式成型机进行打印制作;(16) Input the guide plate designed in step (15) into the SL 450 three-dimensional printing molding machine for printing;

(17)将步骤(16)打印好的导板采用低温等离子或环氧乙烷低温消毒灭菌。(17) Use low-temperature plasma or ethylene oxide to sterilize the printed guide plate in step (16).

Claims (1)

Translated fromChinese
1.一种适用于股骨颈系统3D打印组合式导板制备方法,其制备方法分为3D骨骼数据采集和导板设计两部分组成,其具体制备方法如下:1. A method for preparing a combined guide plate suitable for 3D printing of the femoral neck system. The preparation method is divided into two parts: 3D bone data collection and guide plate design. The specific preparation method is as follows:骨折三维CT数据采集,Fracture three-dimensional CT data collection,(1)使用三维CT扫描设备将患者患处的骨骼进行扫描;(1) Use three-dimensional CT scanning equipment to scan the patient’s bones in the affected area;(2)将步骤(1)扫描患者患处的三维CT扫描数据,导入CT扫描数据到三维重建软件Mimics 21.0;(2) Scan the three-dimensional CT scan data of the patient’s affected area in step (1) and import the CT scan data into the three-dimensional reconstruction software Mimics 21.0;(3)对步骤(2)中提取的CT扫描原始数据进行优化处理,将髋关节部分的骨头进行逐层分割,先选择各个骨头的灰度进行分割,分别提取股骨、髋骨的各个骨骼信息,而后以区域增长的方式清理各个骨头之间的杂乱信息;(3) Optimize the original CT scan data extracted in step (2), segment the bones of the hip joint layer by layer, first select the grayscale of each bone for segmentation, and extract the bone information of the femur and hip respectively. , and then clean up the messy information between each bone in a region growing manner;(4)将步骤(3)清理完成后的骨头之间的信息采用系统默认的optimal命令把各个骨头根据选取的阈值计算出来;(4) Use the system default optimal command to calculate the information between bones after cleaning in step (3) and calculate each bone according to the selected threshold;(5)使用Mimics 21.0 软件测得股骨颈三维数据,根据测量结果在软件3-Matic中实行预复位;(5) Use Mimics 21.0 software to measure the three-dimensional data of the femoral neck, and perform pre-reduction in the software 3-Matic based on the measurement results;(6)将步骤(5)复位后的股骨颈三维数据使用NX10.0软件把骨钉、中央定位导针和模拟骨钻圆柱的相对位置关系绘制出来导出stl格式备用,然后把模型和股骨信息一起导入到Magics21.0中;(6) Use NX10.0 software to draw the relative positional relationship between the bone nail, central positioning guide pin and simulated bone drill cylinder for the three-dimensional data of the femoral neck after reduction in step (5), export it to stl format for later use, and then convert the model and femoral information Import them into Magics21.0 together;(7)圆柱体与股骨干夹角设计为130°,转动三维结构中的圆柱体,缓慢拖动滚轴,分别在3D界面、横断面、矢状面、冠状面观察圆柱体通过股骨颈的位置关系,进而完成股骨颈动力抗旋交叉钉系统的模拟安全钉道设计;(7) The angle between the cylinder and the femoral shaft is designed to be 130°. Rotate the cylinder in the three-dimensional structure, slowly drag the roller, and observe the movement of the cylinder through the femoral neck on the 3D interface, transverse plane, sagittal plane, and coronal plane. Positional relationship, and then complete the simulated safe nail track design of the femoral neck dynamic anti-rotation cross nail system;(8)观察模拟安全钉道和骨钉是否穿破股骨颈及股骨头,并根据观察结果对模拟安全钉道和骨钉做适当微调,以确保股骨颈动力抗旋交叉钉系统模拟安全钉道的安全性及准确性;(8) Observe whether the simulated safety nail path and bone nail penetrate the femoral neck and femoral head, and make appropriate fine adjustments to the simulated safety nail path and bone nail based on the observation results to ensure that the femoral neck dynamic anti-rotation cross nail system simulates a safe nail path safety and accuracy;导板设计由中央导针导向孔设计、抗旋导针导向孔设计、小粗隆定位固定导向孔设计、可装卸固定基座设计组成,The guide plate design consists of a central guide pin guide hole design, an anti-rotation guide pin guide hole design, a lesser trochanter positioning and fixing guide hole design, and a removable fixed base design.(9)使用Magics21.0软件按照模拟安全钉道的轨迹轴心线设定钉道直径,将中央导针导向孔内径设计为3.2 mm,外径为7.5 mm,导针尖部距离软骨下骨5 mm;(9) Use Magics21.0 software to set the diameter of the nail path according to the trajectory axis of the simulated safe nail path. Design the inner diameter of the central guide pin guide hole to be 3.2 mm and the outer diameter to be 7.5 mm. The distance between the tip of the guide pin and the subchondral bone is 5 mm;抗旋导针导向孔设计Anti-rotation guide pin guide hole design(10)使用Magics21.0软件按照模拟安全钉道的轨迹轴心线设定一平行于中央导针的轴心线,两轴心线之间的距离为8 mm,将抗旋导针导向孔内径设计为3.2 mm,外径为7.5mm,导针尖部距离软骨下骨5 mm;(10) Use Magics21.0 software to set an axis parallel to the central guide pin according to the trajectory axis of the simulated safety nail path. The distance between the two axis lines is 8 mm. Guide the anti-rotation guide pin into the hole. The inner diameter is designed to be 3.2 mm, the outer diameter is 7.5 mm, and the distance between the tip of the guide needle and the subchondral bone is 5 mm;小粗隆定位固定导向孔设计Design of guide holes for positioning and fixation of the lesser trochanter(11)使用Magics21.0软件设计一垂直于股骨干,平行于小粗隆下缘的定位固定导向孔,导向孔内径设计为2.1 mm,外径为7.5 mm;(11) Use Magics21.0 software to design a positioning and fixation guide hole perpendicular to the femoral shaft and parallel to the lower edge of the lesser trochanter. The inner diameter of the guide hole is designed to be 2.1 mm and the outer diameter is 7.5 mm;可装卸固定基座设计Removable fixed base design(12)使用Geomagic 2019软件提取股骨大粗隆外侧壁表面解剖数据,将这个表面数据导入到Magics21.0并做反向偏移2.0 mm处理,将偏移表面和原始表面合并、填充和优化,建立与股骨大粗隆外侧壁解剖形态一致的方向基座,基座上缘与股外侧肌嵴平行,上缘宽2cm;基座下缘与小粗隆下缘平行,下缘宽3 cm;(12) Use Geomagic 2019 software to extract the anatomical surface data of the lateral wall of the greater trochanter of the femur. Import this surface data into Magics21.0 and perform reverse offset processing of 2.0 mm. Merge, fill and optimize the offset surface and the original surface. Establish a directional base consistent with the anatomical shape of the lateral wall of the greater trochanter of the femur. The upper edge of the base is parallel to the vastus lateralis muscle crest, and the upper edge is 2 cm wide. The lower edge of the base is parallel to the lower edge of the lesser trochanter, and the lower edge is 3 cm wide.(13)将步骤(12)的基座同时导入三个导向孔数据,两者组合重建导向模板雏形,形成定位导向孔的股骨颈动力抗旋交叉钉系统的导航模板,根据导向孔的位置把导板一分为二,使其分割线在导向孔最大分开处,生成上下2个组合式导板;(13) Import the base of step (12) into three guide hole data at the same time, and combine the two to reconstruct the prototype of the guide template to form a navigation template for the femoral neck dynamic anti-rotation cross-nail system that locates the guide holes. According to the position of the guide holes, The guide plate is divided into two, so that the dividing line is at the maximum separation of the guide holes, creating two combined guide plates, upper and lower;(14)将步骤(13)生成上下2个组合式导板运用布尔运算后,贯通导向模板钉道,并对边界进行修整,完成组合式导板的设计;(14) Apply Boolean operations to the upper and lower combined guide plates generated in step (13), penetrate the guide template nail path, and trim the boundaries to complete the design of the combined guide plate;(15)在步骤(14)的导板基础上使用NX10.0软件设计3个内径为7.6 mm外径为8.5mm高为5mm的圆环;(15) Based on the guide plate in step (14), use NX10.0 software to design three rings with an inner diameter of 7.6 mm, an outer diameter of 8.5mm, and a height of 5mm;(16)将步骤(15)设计好的导板输入到SL450三维立体打印方式成型机进行打印制作;(16) Input the guide plate designed in step (15) into the SL450 three-dimensional printing molding machine for printing;(17)将步骤(16)打印好的导板采用低温等离子灭菌。(17) Use low-temperature plasma to sterilize the guide plate printed in step (16).
CN202210003999.XA2022-01-052022-01-05 A preparation method for 3D printing combined guide plate suitable for femoral neck systemActiveCN114271920B (en)

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