数字化设计结合3D打印技术在拇指再造中的应用

目的　通过数字化设计，结合3D打印技术实现拇指缺损再造供区面积准确、个性化及优化的选择。 方法　采集7例拇指受伤缺损患者双手及双足CT扫描数据，在Mimics软件中重建双手模型，根据左右手互为镜面投影的原理，利用Mimics软件自带“Mirror”功能生成健侧手的镜像，利用生成的镜像实现对拇指缺损的部分的虚拟形态学上的恢复，再进行数字化模拟对比和切割等操作，可以得到缺损拇指部分的三维形态模型；利用3D打印技术将生成的缺损模型打印出来，在缺损部分实物模型上贴上医用胶布包裹修剪，制作好的样布可以准确地指导供区的选择。 结果　7例拇指缺损患者均采用数字化设计结合3D打印技术进行拇指再造供区面积的选择，再造后拇指外观形态高度接近未受伤前，功能恢复快、效果好，患者反映良好。 结论　数字化设计结合3D打印技术可以实现拇指缺损供区面积准确、个性化及优化的选择。

The application of digital design combined with 3D printing technology in thumb reconstruction

Objective　An accurate, personal and optimal realization for the choice of donor site area in thumb reconstruction via digital design combined with 3D printing. Methods CT scanning data of both hands and both feet of 7 patients with wounded thumbs were collected. The virtual models of both hands were reconstructed using Mimics. According to the principle that both hands are mirror projection to each other, we can rebuild the mirror image of the uninjured hand in Mimics with one of its features-the mirror option. Thus we could complete the virtual morphological restoration of the defect of the wounded thumb by referring to the mirror projection. Thereafter, using digital virtual comparison and virtual incision, we could get the three-dimensional configuration model of the defect of the thumb. The physical model of the virtual model was produced by using 3D printing technology whereby we could tape the adhesive plaster. Finally, the chosen area of the donor site could be obtained by fixing the taped plaster under the precise direction. Results Totally, the 7 thumb-wounded patients were subject to the digital design combined with 3D printing technology when referring to the choice of their donor site. The physical appearance of the rebuild thumbs were highly resembled to the unwounded state. A rapid restoration of the functions, a favorable effect and a nice feedback from the patients were obtained. Conclusions Digital design combined with 3D printing can make an accurate, personal and optimal decision in the choice of donor site in thumb reconstruction.