数字化定制胫骨骨折个体化内固定钢板及其微创手术用模板

目的 探讨胫骨骨折个体化有限接触动态加压钢板（limited contact dynamic compression plate， LC-DCP）及其模板的定制过程、方法，以及临床初步使用疗效。方法 利用螺旋CT三维图像重建、计算机辅助设计和制造以及数控仿真加工技术定制出应用于胫骨骨折微创手术的数字化LC-DCP和模板，并用于治疗胫骨骨折6例。 结果 定制出胫骨骨折的个体化LC-DCP并成功应用于临床，所有患者平均20月随访发现，术后骨折均达到临床愈合，根据Johner-Wruhs评分标准，优5例，良1例。结论 个体化钢板制作流程简单，可行性强，结合微创技术治疗胫骨骨折具有操作简单、损伤小、骨折复位固定满意、愈合率高、并发症少等优点，值得临床推广。

Individualized internal fixation plate for tibial fracture by digital customization and template for minimally invasive surgery

Objective To investigate the process and method of making an individualized limited contact dynamic compression plate (LC-DCP) and template for fixing tibial fracture, as well as its preliminary effect in clinic. Methods The custom-made tibia LC-DCP and the template used in minimally invasive percutaneous plate osteosynthesis (MIPPO) surgery were developed by 3D reconstruction of CT images, computer-aided design/manufacturing (CAD/CAM) and computer numerical control (CNC) technology, and then applied in 6 patients with tibial fractures. Results The individualized tibia LC-DCP was successfully used in clinic. The average 20-month follow-up showed that all fractures were healed in 6 patients, with 5 reaching excellent and 1 reaching good standard, according to criteria of Johner-Wruhs. Conclusions The production process of such individualized plate is simple and practicable, and has the advantages of simple operation, less injury, satisfactory reduction and fixation, high healing rate, less complexity when treating tibial fracture in MIPPO surgery. Therefore, it is worth of clinical application.