3D Digital Orthopedic Technolgy Is The Basic Research In The Clinical Treatment And Steel Plate Design Of Ankle Fractures

Objectives:Using 3D printing combined with computer aided software technology for the treatment of ankle fracture with conventional comparative study on the traditional surgical treatment for analysis,evaluation and applicational of 3D digital orthopaedic technology advantages for the treatment of fractures;at the same time based on the basic research of anatomic locking plate of the ankle,the value and advantages of 3D digital orthopedic techopedic technology in the production of orthopedic internal fixation devices were analyzed.Methods:1.The ankle joint of 60 patients with ankle fracture admitted by the first affilliated hospital of kunming medical university from August 2016 to May 2018 was selected for CT scan data,the three models of ankle joint were reconstructed in the software of MIMICS 14.0,and then the proprotion entity model was printed out.At the same time,60 patients with ankle joint fracture were randomly divided into long regulation group and control group.regulation group set by traditional open reduction internal fixation treatment of ankle fractures,the control group in the 3D printing will ankle entity model based on the shape and internal fixation,simulating fixation implant position,screw angle and the parameters such as length,used in the actual surgery after debugging.Comparison and analysis of two groups of therapeutic effects,avarage X-ray exposure,length of hospital time;intraoperative,blood loss,surgical pain visual simulation VAS score,postoperative recovery time,ASIA score.2.At the same time the CT data of 20 normal ankles were imported into software Mimics in.dicom format for three dimensional reconstruction of the ankle joint.The within the inside of the turn angle and the after the lateral varus angle of the posterior ankle,the twist height in the sagittal plane and the height of security zone for screw insertion in the posterior ankle cross—section were measured.The anatomic plate for the posterior ankle designed on the basis of 3 D reconstruction of the ankle joint using the software Mimics,CT and 3D printing.The 3D printing was used to manufacture models of the anatomic plate which were tested and evaluated on the 15 fresh cadaver specimen.Results:1.There was no statistically significant(P>0.05)difference between the control group and the conventional group in age,gender and fracture type analysis.The effective rate of the control group was 93.3%(28/30),which Was significantly higher than that of the regulation group 66.7%(20/30)(P<0.05).The operation time,hospitalization,avarage X-ray exposure,blood loss,surgical pain visual simulation VAS score and postoperative recovery time of the control group were less than those of the regulation group,and the ASIA score was more than the regulation group,the difference wag statistically significant(P<0.05).2.The measurements showed that the within the inside of the turn angle and the after the lateral varus angle of the posterior ankle increased gradually from the central axis of posterior ankle,while the twist height reduce from the external to the internal.The Computer aided technology design of the plate was achieved on the basis of the measurement data.The anatomic models of the plate fit the 15 fresh cadaver specimen of posterior ankle very well.Conclusions:1.The application of 3D printing combined with computer-aided technique in the treatment of ankle fractures,which can reduce the operation time,hospitalization,avarage X-ray exposure,blood loss,surgical pain visual simulation VAS score and postoperative recovery time,improve therapeutic effect and the ASIA score.that reducing the risk of surgical failure,improve the accurate observation of the fracture site and consolidate the clinical therapeutic effect.At the same time,it provides important guidance significance and clinical reference value for the development of orthopaedic surgery in the future.2.The 3D digital orthopaedic technology to design of the ankle after anatomic locking plate can make internal fixation in bone anatomical morphyology,heip fracture anatomical repositioning,intraoperative no shape to minimally invasive surgery and bone surface fit closely to achieve,for the design of the internal fixtaion devices provide some valuable reference idea and method.at the same time for future development proides an important guiding significance to the orthopaedic surgery and clinical reference value.