计算机辅助截骨模板在Steel三相截骨治疗儿童先天性髋关节脱位中的应用

目的利用计算机辅助设计为儿童先天性髋关节脱位采用Steel三相截骨矫正手术方案的制定和实施提供一种相对精确
的截骨方案。方法选择13例拟行Steel三相截骨手术治疗的单侧先天性髋关节脱位患儿，术前对患者骨盆行连续螺旋CT连续
断层扫描，将原始Dicom格式数据导入Materialise Mimics 14.1软件，三维重建髋关节，以.stl格式保存，导入Imageware 12.0软
件，通过镜像重建患髋矫形后位置，模拟Steel三相截骨，建立截骨模板，通过快速成型技术生成模板实体，指导手术。结果通过
术后X线片和术后1年随访，髋臼指数平均为19.1°±3.2°，头臼包容关系明显改善。X线评定优良率为92.31%。结论计算机辅
助截骨模板可以为Steel三相截骨治疗儿童先天性髋关节脱位提供一种个性化、相对精确截骨方案。

Application of computer-aided osteotomy template design in treatment of developmental dysplasia of the hip with steel osteotomy

Objective To provide an accurate method for osteotomy in the treatment of developmental dysplasia of the hip with
steel osteotomy by three-dimensional reconstruction and Reverse Engineering technique. Methods Between January 2011 and
December 2012, 13 children with developmental dysplasia of the hip underwent steel osteotomy. 3D CT scan pelvic images
were obtained and transferred via a DICOM network into a computer workstation to construct 3D models of the hip using
Materialise Mimics 14.1 software in STL format. These models were imported into Imageware 12.0 software for steel osteotomy
simulation until a stable hip was attained in the anatomical position for dislocation or subluxation of the hip in older children.
The osteotomy navigational templates were designed according to the anatomical features after a stable hip was reconstructed.
These navigational templates were manufactured using a rapid prototyping technique. Results The reconstruction hips in
these children show good matching property and acetabulum cover. Conclusion The computer-aided design of osteotomy
template provides personalized and accurate solutions in the treatment of developmental dysplasia of the hip with steel
osteotomy in older children.