Establishment of digital template of cannulated screw fixation for femoral neck fractures

doi:10.3969/j.issn.2095-4344.2014.31.017

Abstract

Abstract:

BACKGROUND: In accordance with AO principles of fracture treatment, the tendency of femoral neck fracture is to cut open articular capsule, clean hematoma, carry out dissection and reduction, strengthen internal fixation, not necessary to suture articular capsule, resulting in decreasing the incidence of avascular necrosis. Cannulated screw placement for femoral neck fracture is a key to stabilize the structure. However, accuracy of nail placement is greatly affected by individual difference, two-dimensional imaging equipment for pedicle screw positioning and physician’s experiences. An assisted pedicle screw method that has strong practicability, low cost, and is easily spread to be used is urgently needed.
OBJECTIVE: To construct three-dimensional models of femoral neck fractures with cannulated compression screw, to precisely establish navigation template using three-dimensional bio-printing technology and to verify.
METHODS: After 18 volunteers signed informed consent. Continuous spiral CT was used to scan bilateral upper end of the femur via encryption. Dicom data were loaded into Amira 3.1 software for reconstructing three-dimensional fracture models, and then these data were loaded into Image-ware12.1 software. The best puncture channel was designed digitally. Three-dimensional models of femoral neck fractures with screw were reconstructed. Anatomic morphology was extracted, and reverse template was established. Physical template was printed with three-dimensional bio-printing technology, and verified by surgical simulation.
RESULTS AND CONCLUSION: Three-dimensional models of femoral neck fractures and models of cannulated screw were successfully established. Digital channel and optimal puncture pathway were designed, and navigation template was made. Screw placement during surgical simulation was in the optimal position. Produced three-dimensional model well adhered to navigation template in vitro. After successful puncture, fault verified that the position of puncture channel was exact. These findings indicated that three-dimensional models of digital simulated femoral neck fracture fixation were successfully established. Reverse engineering and three-dimensional bio-printing technology improve the accuracy of surgical procedures, and provide theoretical basis and technical support for the clinic.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: internal fixators, imaging, three-dimensional, femur neck

CLC Number:

R318

Cao Zhen-hua, Yin He-ping, Li Shu-wen. Establishment of digital template of cannulated screw fixation for femoral neck fractures[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(31): 5017-5023.

Figures/Tables 2

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