| 研究生: |
詹皓羽 Hao-Yu CHAN |
|---|---|
| 論文名稱: |
電腦輔助跟骨骨折復位與骨板置放模擬技術發展 |
| 指導教授: |
賴景義
Jiing-Yih Lai |
| 口試委員: | |
| 學位類別: |
碩士 Master |
| 系所名稱: |
工學院 - 機械工程學系 Department of Mechanical Engineering |
| 論文出版年: | 2019 |
| 畢業學年度: | 107 |
| 語文別: | 中文 |
| 論文頁數: | 109 |
| 中文關鍵詞: | 跟骨骨折 、骨板置放模擬 、跟骨復位 、術前分析 |
| 外文關鍵詞: | Calcaneal fracture, implant placement, calcaneus reduction, preoperative analysis |
| 相關次數: | 點閱:13 下載:0 |
| 分享至: |
| 查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
在跟骨骨折的治療中,其最終目標是將跟骨恢復至如同健康狀態時之外型,再將骨釘或是骨板固定於跟骨表面上。傳統的跟骨骨折治療亦如同其他的骨折治療,不論是骨組織復位或骨板置放,不但需要花費大量時間,也可能在復位與固定處理時發生問題,而為了減少手術時間並提升手術成功率,已經有許多醫院開始嘗試使用電腦輔助手術系統。本研究使用PhysiGuide軟體作為研究工具,將電腦斷層掃描影像生成三維模型來進行手術模擬,並且對其中復位處理與骨板置放模擬功能改良後,提供一半自動曲線復位法,與跟骨骨板置放模擬功能,並且以數個跟骨骨折案例測試,說明改良後之術前分析流程的可行性,最後亦利用形態量測學參數檢驗復位功能之合理性。
In calcaneal fractures management, the ultimate goal is to restore the fractured parts into their anatomy position, then fix them by using bone nail or bone implant. Traditionally, it requires a lot of time and produces error of prone to perform bone reduction and fixation. To deal with this issue, computer-aided surgery system has recently been developed. In this study, we apply hysiGuide software to generate three-dimensional model of a fractured bone directly from CT images and conduct a virtual surgery simulation. The result shows that our study improves the bone reduction and fixation function, and provide a semi-automatic curve reduction function and a simulated function for calcaneal implant placement. In addition, we also demonstrate the feasibility of the preoperative analysis process by testing several calcaneal fracture cases. Finally, the morphological measurement parameters are used to verify the rationality of the bone reduction function.
[1] D. B. Thordarson and L. E. Krieger, " Operative vs. nonoperative treatment of intra-articular fractures of the calcaneus: a prospective randomized trial," Foot & Ankle International, Vol. 17, No. 1, pp. 2-9, 1996.
[2] H. Zwipp, H. Tscherne, H. Thermann and T. Weber, "Osteosynthesis of displaced intraarticular fractures of the calcaneus. Results in 123 cases," Clinical Orthopaedics and Related Research, Vol. 290, pp. 76-86, 1993.
[3] R. Sanders, "Radiological evaluation and CT classification of calcaneal fractures," Disorders of the Foot and Ankle, Vol. 3, pp. 2326-2354, 1990.
[4] R. Sanders, "Intra-articular fractures of the calcaneus: present state of the art," Journal of Orthopaedic Trauma, Vol. 6, No. 2, pp. 252-265, 1992.
[5] R. Sanders, P. Fortin, T. DisPasquale and A. Walling, "Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification," Clinical Orthopaedics and Related Research, Vol. 290, pp. 87-95, 1993.
[6] P. J. Huang, H. T. Huang, T. B. Chen, J. C. Chen, Y. K. Lin, Y. M. Cheng and S. Y. Lin, "Open reduction and internal fixation of displaced intra-articular fractures of the calcaneus," Journal of Trauma and Acute Care Surgery, Vol. 52, No. 5, pp. 946-950, 2002.
[7] R. M. Satava, "Virtual reality surgical simulator," Surgical Endoscopy, Vol. 7, No. 3, pp. 203-205, 1993.
[8] H. Bäthis, L. Perlick, M. Tingart, C. Lüring, D. Zurakowski and J. Grifka, "Alignment in total knee arthroplasty: a comparison of computer-assisted surgery with the conventional technique," The Journal of Bone and Joint Surgery, Vol. 86-B, No. 5, pp. 682-687, 2004.
[9] S. L. Delp, D. S. Stulberg, B. Davies, F. Picard and F. Leitner, "Computer assisted knee replacement," Clinical Orthopaedics and Related Research, Vol. 354, pp. 49-56, 1998.
[10] V. Bagaria, S. Deshpaned, D. D. Rasalkar, A. Kuthe and B. K. Paunipagar, "Use of rapid prototyping and three-dimensional reconstruction modeling in the management of complex fractures," European Journal of Radiology, Vol. 80, No. 3, pp. 814-820, 2011.
[11] S. P. Sun, Y. J. Chou and C. C. Sue, "Full-scale 3D preoperative planning system for calcaneal osteotomy with a multimedia system," The Journal of Foot and Ankle Surgery, Vol. 48, No. 5, pp. 528-539, 2009.
[12] Britannica. https://www.britannica.com/science/foot
[13] P. S. Arun, "Calcaneus anatomy and attachments," Retriveved from https://boneandspine.com/calcaneus-anatomy-and-attachments
[14] J. L. Marsh, T. F. Slongo, J. Agel, J. S. Broderick, W. Creevey, T. A. Decoster, L. Prokuski, M. S. Sirkin, B.Ziran, B. Henley and L. Audigé, "Fracture and dislocation classification compendium-2007: orthopaedic trauma classification, database and outcomes committee," Journal of Orthopaedic Trauma, Vol. 21, No. 10, pp. S92-S93, 2007.
[15] A. R. Demcoe, M. Verhulsdonk and R. E. Buckley, "Complications when using threaded K-wire fixation for displaced intra-articular calcaneal fractures," Injury, Vol. 40, No. 12, pp. 1297-1301, 2009.
[16] 羅賴鈞,醫學影像之三維顯示與骨組織三角網格重建技術探討,國立中央大學碩士論文,2009。
[17] 張紹德,虛擬X光與C-arm影像之模擬技術發展,國立中央大學碩士論文,2011。
[18] 胡育昇,電腦輔助骨盆骨折術前規劃系統發展,國立中央大學碩士論文,2011。
[19] 俞首安,電腦輔助骨盆骨折術前評估系統發展,國立中央大學碩士論文,2010。
[20] 馮建霖,骨創傷手術術前規劃系統之臨床實驗與應用,國立中央大學碩士論文,2013。
[21] Econstruction Plate-3.5. https://www.orthopaedic-implants.com/small-fragment-system/standard-implants/plates/pelvic-reconstruction-plates-ss.php
[22] Safety Lock Calcaneal Plate. https://www.indiamart.com/proddetail/safety-lock-calcaneal-plate-20113696355.html
[23] K. S. Arun, T. S. Huang and S. D. Blostein, “Least-squares fitting of two 3D point sets,” IEEE Transactions on Pattern Analysis and Machine Intelligence, Vol. 9, pp. 698-700, 1987.
[24] 莊曜瑋,電腦輔助下顎骨切割與重建手術規劃,國立中央大學碩士論文,2011。
[25] Irwansyah, J. Y. Lai, T. Essomba and P. Y. Lee, "Measurement and analysis of calcaneus morphometric parameters from computed tomography images," International Conference on Bioinformatics and Biomedical Engineering, 2018.