摘要目的 利用踝关节的CT三维重建数据结合计算机辅助技术软件设计后踝解剖锁定钢板. 方法 利用Mimics 10.01软件对20例志愿者的正常踝关节进行CT扫描和三维重建,测量后踝的内侧内翻角、外侧内翻角、扭曲高度、置入螺钉安全区高度、后踝后唇宽度等解剖学指标.采用Ungraphics NX5.0软件设计后踝解剖锁定钢板.应用3D打印技术等比例(1∶1)制作后踝解剖锁定钢板模型,将钢板模型置于15例成人新鲜尸体后踝部(去除后踝部全部软组织,完全暴露后踝骨质结构)进行钢板模型验证. 结果 后踝内侧内翻角、外侧内翻角由后踝中轴线向内、外侧逐渐增大,扭曲高度由外向内逐渐降低,后踝宽度由上到下逐渐增宽,置入螺钉安全区由后踝近端到远端安全范围逐渐增大.将3D打印出的钢板模型置于15例成人新鲜尸体后踝部,发现钢板与后踝匹配度合适、安放位置与角度理想,符合后踝解剖锁定钢板的设计要求. 结论 应用踝关节的CT三维重建数据结合计算机辅助技术软件对后踝解剖锁定钢板进行设计,为计算机辅助技术对内固定器械的设计提供了有价值的参考.

abstractsObjective To design an anatomic locking plate for the posterior malleolus using 3D reconstruction CT of the ankle joint and software Mimics.Methods The CT data of 20 normal ankles were imported into software Mimics in.dicom format for 3D reconstruction of the ankle joint.The angles of posteromedial and posterolateral varus,the twist height on the sagittal plane and the height of safe screw placement zone,the width of the posterior malleolus were measured for the posterior malleolus.After the anatomic locking plate was designed using the anatomic data measured and software Ungraphics NX5.0,it was 3D printed in a proportion of 1:1.Next,the model plate was tested and evaluated in 15 fresh cadaveric specimens of the ankle all the soft tissues of which were removed to fully expose the bony structure of the posterior malleolus.Results The anatomic measurements showed that the angles of postemmedial and posterolateral varus increased gradually towards the medial and lateral sides along the central axis of the posterior malleolus while the twist height reduced from the lateral to the medial side,and that the width of the posterior malleolus increased gradually from the superior to the inferior.It was found that after placement in the 15 fresh cadaveric specimens the anatomic model plate fit the posterior malleolus very well,fulfilling all the designed requirements for the anatomic locking plate for the posterior malleolus.Conclusion A novel anatomic locking plate for the posterior malleolu has been successfully designed and manufactured using 3D reconstruction CT of the ankle joint,software Mimics and 3D printing.