Clinical Application Of Three-dimensional Reconstruction With Internal Fixation Operation For Rib Fracture

Objective:To use of the existing computer technology and business softwares integrate the fractured ribs patients’image data,in order to conclude the3d model of thoracic and the surgery simulation of ribs fixed,and then evaluate the significance of surgery simulation to the real operation process.Materials and methods:Collect the detailed image informations of the17fractured rib patients injured on traumatism in our hospital, asking do chest CT scans and chest radiograph both before and after the operation. Obtain the data of the width (A1) of the fractured rib and the span of fracture line(B1) according to the chest radiograph.Then migrate the chest CT data into software of Mimics by DICOM format,making a series of technical treatments,receive the patients’3d thoracic models. After that migrate this model into3ds Max by VRML,another commercial software.To do operation simulation,calculate and measure the width of the rib(A2), the span of the fracture line(B2)and the encircle radian (C)of embracing fixator used in simulation operation. Afterwards Participate the operation process of internalfixationoffracture and measure the width of the rib(A3), the span of the fracture line(B3) and the encircle radian of embracing fixator(C1) in the real operation.Results:The consistency examination maked respectively between A3to A1and A2to A3, their respective intraclass correlation coefficient (ICC) and95%confidence interval of ICC (ICC95%) were0.735(0.606,0.826) and0.897(0.839,0.934), and both ICC95%do not overlap; In the same way the ICC and ICC95%between B1toB2and B2to B3were0.943(0.910,0.964) and0.997(0.995,0.998), both ICC95%overlap. Analyze C To Clwith the matched t test, in the α=0.05level is still can’t believe that the overall mean differences are statistically significant difference.(t=1.718, p=0.096)Conclusion:1. In the chest3d model, the measured value Of the span of rib fracture line is closer to the measured values from real surgery operation than the preoperative data root in plane image.2. The radian of embracing fixator used in the3d model and real operation is basically the same.3. Preoperative Surgery Simulation of internalfixationoffracture can not only allow the situation to be comprehensived more lealistically, inutilly,and more stereoscopically,and it can provide dynamic cognition before the real surgery operation,assist doctors in finding accurater operation road, better surgery program,more reasonable exposure,and then reduce suffering and obtain the best curative.