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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
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  • 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.

    摘要 I Abstract II 致謝 III 目錄 IV 圖目錄 VI 表目錄 IX 第一章 緒論 1 1.1 前言 1 1.2 文獻回顧 2 1.2.1 跟骨骨折治療方式 2 1.2.2 電腦輔助手術系統之發展 3 1.3 研究背景說明 5 1.4 研究目的與方法 6 1.5 論文架構 9 第二章 跟骨創傷手術與PhysiGuide軟體說明 10 2.1 跟骨與跟骨骨折及醫療方式 10 2.2 PhysiGuide軟體說明 17 2.3 PhysiGuide應用於跟骨創傷術前分析 26 2.3.1 術前分析流程 28 2.3.2 跟骨案例不適用之原因說明 32 第三章 骨組織復位法改善與骨板放置模擬發展 38 3.1 前言 38 3.2 骨組織復位法 39 3.2.1 現有復位法說明 39 3.2.2 點對點半自動曲線復位法 40 3.3 跟骨之不規則骨板放置模擬 47 第四章 範例驗證及探討 67 4.1 前言 67 4.2 實際案例模擬與驗證 67 4.2.1 實際案例模擬 68 4.2.2 復位正確性之檢測 84 4.3 問題探討 90 第五章 結論與未來展望 92 5.1 結論 92 5.2 未來展望 93 參考文獻 94

    [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.

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