CN111134861A - Fixed positioning guide plate for transfixion of femoral anterolateral embedded flap and branch blood vessel and manufacturing method thereof - Google Patents
Fixed positioning guide plate for transfixion of femoral anterolateral embedded flap and branch blood vessel and manufacturing method thereof Download PDFInfo
- Publication number
- CN111134861A CN111134861A CN202010029251.8A CN202010029251A CN111134861A CN 111134861 A CN111134861 A CN 111134861A CN 202010029251 A CN202010029251 A CN 202010029251A CN 111134861 A CN111134861 A CN 111134861A
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- flap
- guide plate
- positioning guide
- anterolateral
- femoral
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
- B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
- B29C64/00—Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
- B29C64/10—Processes of additive manufacturing
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
- B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
- B29C64/00—Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
- B29C64/30—Auxiliary operations or equipment
- B29C64/386—Data acquisition or data processing for additive manufacturing
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y10/00—Processes of additive manufacturing
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y50/00—Data acquisition or data processing for additive manufacturing
Abstract
The invention discloses a fixed positioning guide plate for a femoral anterolateral embedded flap perforator, which comprises a positioning guide plate body, fixed ends and connecting rods, wherein each fixed end comprises a knee joint fixed end and an anterior superior iliac spine fixed end, two connecting rods are connected between the knee joint fixed end and the anterior superior iliac spine fixed end, and the connecting rods are connected with the positioning guide plate body. The manufacturing method comprises the following steps: (1) firstly, CTA original DICOM data is obtained; (2) performing three-dimensional modeling according to DICOM data, and determining specific position information; (3) positioning the precise position of the flap; (4) determining a body surface reference position and coordinates; (5) and (4) printing the positioning guide plate by a 3D printer according to the data and the position information determined by the methods (1) to (4). The invention can realize the accurate positioning of the flap perforator, especially the synchronous accurate positioning of two perforator embedded with the flap, ensures that the perforator is not damaged in the flap cutting process, and is more accurate, safe, reliable and convenient compared with the traditional mode.
Description
Technical Field
The invention belongs to the field of medical instruments, and particularly relates to a fixed positioning guide plate for a femoral anterolateral chimeric flap perforator and a manufacturing method thereof.
Background
The embedded skin flap is mainly used for repairing and reconstructing various soft tissue defects including oral cavity, jaw and face parts, and is particularly suitable for the synchronous reconstruction of defects of a plurality of parts. However, the anatomical variation of the blood vessel is large, so that it is difficult to successfully locate the blood vessel and prepare the skin flap. In order to ensure the survival rate of the skin flap, the success or failure of the skin flap transplantation is directly determined by accurate positioning and preservation of the branch-crossing blood vessel. At present, the positioning of the transfixion vessel of the femoral anterolateral chimeric flap still depends on the traditional method, and the defects are as follows: the position of the perforator vessel is judged manually by sonar according to the conventional standard anatomical position and an ultrasonic instrument. On one hand, the mode has higher requirement on the environment and is easy to be interfered by noise to form misjudgment, and on the other hand, the individualized anatomical characteristics of the patient, such as vascular development deformity or vascular variation, are difficult to grasp; secondly, the doctor can judge the position by the experience, even if the general position is determined, the accuracy is not enough, the incision is inaccurate, or the skin flap is accidentally injured to supply blood vessels, so that the operation fails.
Therefore, how to solve the above technical problems becomes a problem to be solved urgently by those skilled in the art.
Disclosure of Invention
The invention aims to provide a fixed positioning guide plate for a transfixion vessel with a flap embedded in the front and the outer sides of a thigh and a manufacturing method thereof, which can completely solve the defects of the prior art.
The purpose of the invention is realized by the following technical scheme:
the utility model provides a fixed location baffle of a ramus is worn to outer gomphosis flap before thigh, this location baffle is including location baffle body, stiff end and connecting rod, the shape of location baffle body is according to the defective size of soft tissue with surely get the size of flap and wear a position determination, the stiff end includes anterior eminence stiff end and knee joint stiff end, and the knee joint stiff end is used for the cooperation to connect the knee joint, and the eminence stiff end is used for the cooperation to connect the anterior eminence of ilium before the ilium, connect through two connecting rods between knee joint stiff end and the anterior eminence stiff end, location baffle body is connected to the connecting rod, and location baffle body divide into interconnect's first location baffle body and second location baffle body.
Further, the location baffle is printed through the 3D printer and is formed.
A manufacturing method of a fixed positioning guide plate for a femoral anterolateral chimeric flap perforator, which comprises the fixed positioning guide plate for the femoral anterolateral chimeric flap perforator, comprises the following steps:
(1) firstly, performing bilateral lower limb CTA (computed tomography angiography) examination on a patient to obtain CTA original DICOM data;
(2) carrying out three-dimensional modeling according to original DICOM data of a patient, and determining specific position information including bones, muscles, blood vessels and skin;
(3) designing a skin flap transplantation shape according to the skin flap transplantation requirement, and positioning an accurate position of the skin flap;
(4) determining a body surface reference position and coordinates according to the personalized human anatomical physical signs;
(5) according to the data and the position information determined by the methods (1) to (4), the fixed positioning guide plate for the transfixion vessel of the femoral anterolateral chimeric flap can be printed out by a 3D printer.
Further, the skin flap in the method (3) is a thigh anterolateral chimeric skin flap, the thigh anterolateral chimeric skin flap belongs to a donor area skin flap, a recipient area is a defect wound surface of an oral jaw face or other parts of a body, the number, size and shape of the donor area thigh anterolateral skin flap are selected according to the number, size and shape of defects, and accurate positioning can be performed according to skin puncture of a computer-assisted surgery simulated blood vessel.
Compared with the prior art, the invention has the beneficial effects that: the accurate positioning of the flap perforator, especially the synchronous accurate positioning of two perforator of the embedded flap, can be realized, the flap cutting process is ensured not to damage the perforator, the success rate of flap transplantation is improved, and the method is more accurate, safe, reliable and convenient compared with the traditional method.
Drawings
FIG. 1 is a schematic structural view of a positioning guide.
FIG. 2 is a schematic view of a positioning guide for determining the position of a guide body through a perforator.
FIG. 3 is a schematic view of a positioning guide matched to a blood vessel and soft tissue.
Reference numerals: the first positioning guide plate body 1, the second positioning guide plate body 2, the connecting rod 3, the knee joint fixing end 5, the anterior superior iliac spine fixing end 4, the external femoral artery descending branch 6 and the lower limb soft tissue 7.
Detailed Description
The invention will be further described with reference to specific embodiments and the accompanying drawings.
In order to overcome the defects of the traditional method for positioning the femoral anterolateral chimeric flap perforator, a 3D printing technology-based femoral anterolateral chimeric flap perforator positioning guide plate is designed. The advantages are that: the accurate positioning of the flap perforator, especially the synchronous accurate positioning of two perforator of the embedded flap, can be realized, the flap cutting process is ensured not to damage the perforator, the success rate of flap transplantation is improved, and the method is more accurate, safe, reliable and convenient compared with the traditional method.
As shown in fig. 1 to 3, a fixed positioning guide plate for a femoral anterolateral chimeric flap perforator, which is manufactured based on a 3D printing technology, comprises a positioning guide plate body, a fixed end and a connecting rod 3. The location baffle body is used for cutting out the flap position according to the simulation of computer aided design, and the location baffle body divide into interconnect's first location baffle body 1 and second location baffle body 2, needs to cut out the flap size according to the defective size of soft tissue and position design, and the shape of position baffle body is designed to the position that combines to wear to prop up again. The fixed end is also designed according to computer assistance, and stable bone is selected as the fixed end, the upper end is selected at the anterior superior iliac spine and is matched and connected with the anterior superior iliac spine, namely the anterior superior iliac spine fixed end 4, and the lower end is selected at the knee joint and is matched and connected with the knee joint, namely the knee joint fixed end 5. The knee joint fixing end 5 is connected with the anterior superior iliac spine fixing end 4 through two connecting rods 3, and the connecting rods 3 are connected with the first positioning guide plate body 1 and the second positioning guide plate body 2.
In the manufacturing process of the positioning guide plate, the fixed position of the positioning guide plate body and the flap cutting position of the positioning guide plate body which need to be determined are emphasized, and the method comprises the following steps:
the fixed position of location baffle body: the upper end of the positioning guide plate selects the anterior superior iliac spine as a fixed end, and the lower end selects the knee joint as a fixed end. The middle part is connected with the fixed ends at the two ends and the positioning guide plate body by a connecting rod 3. According to individual CT data of a patient, selecting relatively stable anatomical positions such as knee joints, ilium and the like from the body surface as coordinates, calculating to obtain the form of the positioning guide plate which is attached to the fixed position of the body surface, the accurate position and shape of the skin flap of the body surface, and designing the form of the positioning guide plate.
The flap of location baffle body surely gets the position: after a perforator blood vessel is found by patient CTA data through a computer, the blood vessel, muscle, skin, skeleton and the like are digitally reconstructed through a three-dimensional reconstruction technology, and the initial coordinate axis position, the incisable length of the blood vessel and the initial blood vessel diameter of the external circumflex femoral artery descending branch 6 are measured by a software measuring tool. The positioning points are designed according to coordinate axis position information of a needed perforator, the positioning points are used as centers to cover the area of the needed intercepting skin to design a flap intercepting ring-shaped guide plate, two flap perforator blood vessels on the front outer side of the thigh are relatively close to each other, the intercepting ring-shaped guide plates are mutually embedded to form a similar 8-shaped intercepting ring-shaped guide plate, the source of the blood vessel is reversely tracked, the body surface position of the perforator blood vessel penetrating through a deep fascia is marked, so that the flap is conveniently cut, and the specific range of the positioning guide plate body is designed.
The specific preparation method of the positioning guide plate in the technical scheme comprises the following steps:
(1) the patient performs bilateral lower limb CTA examination to obtain CTA original DICOM data.
(2) Three-dimensional modeling is performed according to the original CTA data of the patient, and specific position information containing bones, muscles, blood vessels and skin is determined.
(3) According to the requirements of skin flap transplantation, the shape of the skin flap transplantation is designed, and the accurate position of the skin flap is positioned. The skin flap is a thigh anterolateral chimeric skin flap, the thigh anterolateral chimeric skin flap belongs to a donor area skin flap, the recipient area is a defect wound surface of the oral jaw face or other parts of the body, and the number, size and shape of the donor area thigh anterolateral skin flap are selected according to the number, size and shape of defects. In the technical scheme, two soft tissue defects are formed, so that two embedded perforator flaps are designed. The exact position of the flap requires precise positioning according to the skin perforator of the vessel simulated by computer-assisted surgery.
(4) And determining the body surface reference position and coordinates according to the personalized human anatomical physical signs.
(5) The positioning guide plate containing the fixed position, the cutting position and the like is printed through the 3D printer.
The fixed end position is determined by mainly selecting hard tissues of non-soft tissues as the fixed positions, and the positioning guide plate is prevented from being displaced along with the change of body positions or the displacement of soft tissues, and a gray part in fig. 3 is a lower limb soft tissue 7 simulated by a computer.
The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents and improvements made within the spirit and principle of the present invention are intended to be included within the scope of the present invention.
Claims (4)
1. The utility model provides a fixed location baffle of branch blood vessel is worn to outer gomphosis flap before thigh, its characterized in that, this location baffle is including location baffle body, stiff end and connecting rod, the shape of location baffle body is according to the defective size of soft tissue and surely gets the size of flap and wear a position determination, the stiff end includes anterior eminence stiff end and knee joint stiff end, and the knee joint stiff end is used for the cooperation to connect the knee joint, and the anterior eminence stiff end of ilium is used for the cooperation to connect the anterior eminence of ilium, connect through two connecting rods between knee joint stiff end and the anterior eminence stiff end of ilium, location baffle body is connected to the connecting rod, and location baffle body divide into interconnect's first location baffle body and second location baffle body.
2. The fixed positioning guide plate for the transfixion of the skin flap through the branch vessel according to claim 1, wherein the positioning guide plate is printed by a 3D printer.
3. A method for manufacturing a fixed positioning guide plate for a transfixion vessel of a flap embedded in the anterior lateral side of a thigh, which is characterized by comprising the fixed positioning guide plate for the transfixion vessel of the flap embedded in the anterior lateral side of the thigh, according to the claim, and the method for manufacturing the fixed positioning guide plate comprises the following steps:
(1) firstly, performing bilateral lower limb CTA (computed tomography angiography) examination on a patient to obtain CTA original DICOM data;
(2) carrying out three-dimensional modeling according to original DICOM data of a patient, and determining specific position information including bones, muscles, blood vessels and skin;
(3) designing a skin flap transplantation shape according to the skin flap transplantation requirement, and positioning an accurate position of the skin flap;
(4) determining a body surface reference position and coordinates according to the personalized human anatomical physical signs;
(5) according to the data and the position information determined by the methods (1) to (4), the fixed positioning guide plate for the transfixion vessel of the femoral anterolateral chimeric flap can be printed out by a 3D printer.
4. The manufacturing method of the fixed positioning guide plate for the transfixion blood vessel of the femoral anterolateral chimeric skin flap according to claim 3, wherein the skin flap in the method (3) is the femoral anterolateral chimeric skin flap, the femoral anterolateral chimeric skin flap belongs to a donor area skin flap, a recipient area is a defect wound surface of an oral maxillofacial area or other parts of a body, the number, size and shape of the donor area femoral anterolateral skin flap need to be selected according to the number, size and shape of defects, and accurate positioning can be performed according to the skin transfixion of a simulated blood vessel in computer-assisted surgery.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010029251.8A CN111134861B (en) | 2020-01-10 | 2020-01-10 | Fixed positioning guide plate for transfixion of femoral anterolateral embedded flap and branch blood vessel and manufacturing method thereof |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010029251.8A CN111134861B (en) | 2020-01-10 | 2020-01-10 | Fixed positioning guide plate for transfixion of femoral anterolateral embedded flap and branch blood vessel and manufacturing method thereof |
Publications (2)
| Publication Number | Publication Date |
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| CN111134861A true CN111134861A (en) | 2020-05-12 |
| CN111134861B CN111134861B (en) | 2023-04-14 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202010029251.8A Active CN111134861B (en) | 2020-01-10 | 2020-01-10 | Fixed positioning guide plate for transfixion of femoral anterolateral embedded flap and branch blood vessel and manufacturing method thereof |
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| CN (1) | CN111134861B (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114246691A (en) * | 2021-11-24 | 2022-03-29 | 中山大学孙逸仙纪念医院 | Wear a positioner |
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| CN107616839A (en) * | 2017-11-10 | 2018-01-23 | 岳春华 | A kind of flap perforating artery localization method rebuild based on 3D printing |
| CN108670362A (en) * | 2018-01-09 | 2018-10-19 | 浙江省肿瘤医院 | The method for cutting guide plate and determining cut soft tissue replacement flap volume is prepared using digitlization Space Reconstruction and 3D printing technique |
| CN215606100U (en) * | 2021-01-27 | 2022-01-25 | 上海交通大学医学院附属第九人民医院 | Split type cutting guide plate for supporting skin flap on front outer side of thigh |
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2020
- 2020-01-10 CN CN202010029251.8A patent/CN111134861B/en active Active
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107616839A (en) * | 2017-11-10 | 2018-01-23 | 岳春华 | A kind of flap perforating artery localization method rebuild based on 3D printing |
| CN108670362A (en) * | 2018-01-09 | 2018-10-19 | 浙江省肿瘤医院 | The method for cutting guide plate and determining cut soft tissue replacement flap volume is prepared using digitlization Space Reconstruction and 3D printing technique |
| CN215606100U (en) * | 2021-01-27 | 2022-01-25 | 上海交通大学医学院附属第九人民医院 | Split type cutting guide plate for supporting skin flap on front outer side of thigh |
Non-Patent Citations (1)
| Title |
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| 段家章: "数字化技术在股前外侧皮瓣血管解剖学及修复创面中的应用研究", 《硕士学位论文》 * |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114246691A (en) * | 2021-11-24 | 2022-03-29 | 中山大学孙逸仙纪念医院 | Wear a positioner |
| CN114246691B (en) * | 2021-11-24 | 2024-03-15 | 中山大学孙逸仙纪念医院 | Threading and supporting positioning device |
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| Publication number | Publication date |
|---|---|
| CN111134861B (en) | 2023-04-14 |
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