CN111529142A - 一种用于3d打印的距骨假体模型及3d打印距骨假体的成形方法 - Google Patents

一种用于3d打印的距骨假体模型及3d打印距骨假体的成形方法 Download PDF

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CN111529142A
CN111529142A CN202010304627.1A CN202010304627A CN111529142A CN 111529142 A CN111529142 A CN 111529142A CN 202010304627 A CN202010304627 A CN 202010304627A CN 111529142 A CN111529142 A CN 111529142A
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蒋青
李澜
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Abstract

本发明提出了一种用于3D打印的距骨假体模型，包括距骨本体假体模型和关节面假体单元模型，包括若干个关节面假体模型，关节面假体模型通过三维重建技术制作；关节面假体模型形成于距骨本体假体模型的相应关节面上；关节面假体模型以高分子材料为源材料经3D打印形成关节面假体；距骨本体假体模型的相应位置开设若干个韧带附着钉道。本发明解决了植入后的距骨假体活动度大的问题。本发明还提出了一种3D打印距骨假体的成形方法。

Description

一种用于3D打印的距骨假体模型及3D打印距骨假体的成形 方法
技术领域
本发明属于医学技术领域，特别是涉及一种用于3D打印的距骨假体模型及3D打印距骨假体的成形方法。
背景技术
距骨是连接下肢和足部的枢纽，肩负重力传递和运动的耦联，是足部重要的功能单位。距骨位于踝穴内，分别与胫骨远端关节面，跟骨前、中、后关节面和舟状骨形成胫距关节(踝关节)、距下关节和距舟关节，周围韧带附着众多，外形不规则，解剖结构相对复杂。距骨表面约超过2/3的区域为关节软骨所覆盖，血液供应主要来自于内侧三角韧带、关节囊、跗 骨窦、外侧距跟韧带及颈体交界处的踝关节前方关节囊。Hawkins(1970)把距骨颈部骨折分为三型，有报告显示：Ⅰ型缺血坏死率0%～15%、Ⅱ型缺血坏死率20%～30%、Ⅲ型缺血坏死率84%～100%。距骨坏死率与血供受破坏的严重程度有关。当距骨发生坏死后，患者踝关节疼痛、肿胀且病史较长，严重者行走困难，需进行手术。当前手术方式主要有三种，第一种是关节融合术，其优点是症状改善明显，手术操作相对简单，疗效确切，是目前的标准手术，但缺点同样明显，术后康复时间长，有一定不愈合率，丧失关节活动，双侧患者对生活影响较大，周围关节继发退变加快；第二种是髓芯减压术，其优点是手术简单，风险低，缺点是适应症有限，有效率较低；第三种是全踝关节置换术，当前所用踝关节假体的优点是保留关节功能，减轻疼痛，但缺点是适应症很窄，手术操作复杂，风险高，费用高，假体使用寿命有限。
然而，现有技术中的踝关节假体大多由多个部件构成，主要作用是将距骨坏死的关节面替代掉，将距骨主要部分保留，因而设计上采用组配式的半踝关节或全踝关节，但是其主要结构复杂、活动度大，且无法与骨形成良好的长入效果，寿命短。
发明内容
本发明的目的在于提供一种用于3D打印的距骨假体模型及3D打印距骨假体的成形方法，解决了植入后的距骨假体活动度大、距骨假体长入效果差的问题。为实现上述目的，本发明采用如下技术方案：
本发明提出了一种用于3D打印的距骨假体模型，包括距骨本体假体模型，还包括：
一关节面假体单元模型，包括若干个关节面假体模型，所述关节面假体模型通过三维重建技术制作；所述关节面假体模型形成于所述距骨本体假体模型的相应关节面上；所述关节面假体模型以高分子材料为源材料经3D打印形成关节面假体；
所述距骨本体假体模型的相应位置开设若干个韧带附着钉道。
优选地，所述高分子材料为聚乙烯或PEEK材料。
优选地，所述关节面假体单元模型包括距骨滑车关节面假体模型、后距关节面假体模型、中距关节面假体模型和前距关节面假体模型。
优选地，所述韧带附着钉道的直径为5.5m~8mm，深度为10 m~15mm。
优选地，所述距骨本体假体模型的内侧副韧带位置、外侧副韧带位置、距舟背侧韧带位置均对应开设所述韧带附着钉道。
本发明还提出了一种3D打印距骨假体的成形方法，基于所述的用于3D打印的距骨假体模型，包括以下步骤：
（1）对患者足踝部进行CT扫描获取距骨数据，将所述距骨数据在计算机上进行三维重建，获取患者的所述距骨本体假体模型；
（2）在3-matic软件中，在所述距骨本体假体模型的相应位置打孔以获取所述韧带附着钉道；
（3）在3-matic软件中，对距骨本体假体模型的相应关节面处进行mark命令操作，之后用wrap命令操作生成指定厚度的所述关节面假体模型；
（4）以高分子材料为源材料，采用3D技术打印所述关节面假体模型以生成关节面假体；以金属、合金或高分子为源材料，采用3D技术打印所述距骨本体假体模型以生成距骨本体假体；
（5）将所述关节面假体放置在所述距骨本体假体的相应位置处，之后通过螺钉固定所述关节面假体和所述距骨本体假体，以形成距骨假体。
与现有技术相比，本发明的优点为：
（1）距骨本体假体模型上设置韧带附着钉道，该距骨本体假体模型经3D打印形成距骨本体假体，将韧带缝合在距骨本体假体上的韧带附着钉道处。因此，限制了距骨本体假体的活动度。
（2）单独三维重建关节面假体模型，关节面假体模型以高分子材料为源材料进行3D打印形成关节面假体。因此，关节面假体可与周围关节软骨形成较好的缓冲效果，降低了由于距骨假体与宿主关节面模量不匹配造成的关节面磨损的风险。
（3）基于患者的距骨数据进行个性化三维重建，提高了患者的感官体验。
附图说明
图1为本发明一实施例的用于3D打印的距骨假体模型的右视图；
图2为本发明一实施例的用于3D打印的距骨假体模型的左视图
图3~图5为图1中距骨本体假体模型构建韧带附着钉道的示意图；
图6~图8为图1中距骨本体模型执行mark命令时的示意图；
图9~图13为图1中关节面假体模型的结构图。
具体实施方式
下面将结合示意图对本发明进行更详细的描述，其中表示了本发明的优选实施例，应该理解本领域技术人员可以修改在此描述的本发明，而仍然实现本发明的有利效果。因此，下列描述应当被理解为对于本领域技术人员的广泛知道，而并不作为对本发明的限制。
如图1~2所示，一种用于3D打印的距骨假体模型，包括距骨本体假体模型和5个关节面假体模型；距骨本体假体模型上开设7个韧带附着钉道。
距骨本体假体模型经3D打印形成距骨本体假体；关节面假体模型以高分子材料为源材料经3D打印形成关节面假体；关节面假体和距骨本体假体之间通过螺钉固定成一体，以形成距骨假体。
具体的，该距骨假体模型的结构如下：
距骨本体假体模型的相应位置开设7个韧带附着钉道。7个韧带附着钉道的数量分布情况为：如图3所示，在距骨本体假体模型的内侧副韧带位置处，设置2个韧带附着钉道，分别位于距骨本体假体模型的内侧前端和距骨本体假体模型的内侧后端；如图4所示，在距骨本体假体模型的外侧副韧带位置处设置2个韧带附着钉道，分别位于距骨本体假体模型的外侧前端和距骨本体假体模型的外侧后端；如图5所示，在距骨本体假体模型的距舟背侧韧带位置处设置1个韧带附着钉道，该韧带附着钉道位于距骨本体假体模型的前端。
关节面假体单元模型，包括5个关节面假体模型，5个关节面假体模型均通过三维重建技术制作；关节面假体模型形成于距骨本体假体模型的相应关节面上。
如图6所示，距骨本体假体模型的距骨滑车关节面处生成1个距骨滑车关节面假体模型，距骨滑车关节面假体模型如图9所示。
如图7所示，距骨本体假体模型的跗横关节面处生成1个跗横关节面假体模型，跗横关节面假体模型如图10所示。
如图8所示，距骨本体假体模型的后距关节面处、中距关节面处、前距关节面处分别生成后距关节面假体模型、中距关节面假体模型及前距关节面假体模型。如图11~13所示，生成的3个关节面假体模型依次为后距关节面假体模型、中距关节面假体模型和前距关节面假体模型。
在本实施例中，高分子材料为聚乙烯或PEEK材料；金属可采用钽或者不锈钢；合金可采用钛合金或者钴铬钼合金。
在本实施例中，所有韧带附着钉道的直径为5.5m~8mm，深度为10 m~15mm。
本实施例还提出了一种3D打印距骨假体的成形方法，基于前述用于3D打印的距骨假体模型，包括以下步骤：
（1）对患者足踝部进行CT扫描获取距骨数据，将距骨数据在mimics软件中进行三维重建，获取患者的距骨本体假体模型；
（2）在magics软件或者3-matic软件中，在距骨本体假体模型的相应位置打孔以获取上述7个韧带附着钉道；
（3）在3-matic软件中，对距骨本体假体模型的相应关节面处进行mark命令操作，之后用wrap命令操作生成指定厚度的上述5个关节面假体模型；关节面假体模型可以设置为2mm~5mm。
（4）以PEEK为源材料，采用3D技术打印关节面假体模型以生成关节面假体；以不锈钢、钛合金、钴铬钼合金或者钽金属或高分子为源材料，采用3D技术打印距骨本体假体模型以生成距骨本体假体；
（5）将关节面假体放置在距骨本体假体的相应位置处，之后通过螺钉固定关节面假体和距骨本体假体，以形成距骨假体。
上述仅为本发明的优选实施例而已，并不对本发明起到任何限制作用。任何所属技术领域的技术人员，在不脱离本发明的技术方案的范围内，对本发明揭露的技术方案和技术内容做任何形式的等同替换或修改等变动，均属未脱离本发明的技术方案的内容，仍属于本发明的保护范围之内。

Claims (6)

1.一种用于3D打印的距骨假体模型，包括距骨本体假体模型，其特征在于，还包括：
一关节面假体单元模型，包括若干个关节面假体模型，所述关节面假体模型通过三维重建技术制作；所述关节面假体模型形成于所述距骨本体假体模型的相应关节面上；所述关节面假体模型以高分子材料为源材料经3D打印形成关节面假体；
所述距骨本体假体模型的相应位置开设若干个韧带附着钉道。
2.根据权利要求1所述的用于3D打印的距骨假体模型，其特征在于，所述高分子材料为聚乙烯或PEEK材料。
3.根据权利要求1所述的用于3D打印的距骨假体模型，其特征在于，所述关节面假体单元模型包括距骨滑车关节面假体模型、跗横关节假体模型和后距关节面假体模型、中距关节面假体模型和前距关节面假体模型。
4.根据权利要求1所述的用于3D打印的距骨假体模型，其特征在于，所述韧带附着钉道的直径为5.5m~8mm，深度为10 m~15mm。
5.根据权利要求1所述的用于3D打印的距骨假体模型，其特征在于，所述距骨本体假体模型的内侧副韧带位置、外侧副韧带位置、距舟背侧韧带位置均对应开设所述韧带附着钉道。
6.一种3D打印距骨假体的成形方法，基于权利要求1~5之任一项所述的用于3D打印的距骨假体模型，其特征在于，包括以下步骤：
（1）对患者足踝部进行CT扫描获取距骨数据，将所述距骨数据在计算机上进行三维重建，获取患者的所述距骨本体假体模型；
（2）在3-matic软件中，在所述距骨本体假体模型的相应位置打孔以获取所述韧带附着钉道；
（3）在3-matic软件中，对距骨本体假体模型的相应关节面处进行mark命令操作，之后用wrap命令操作生成指定厚度的所述关节面假体模型；
（4）以高分子材料为源材料，采用3D技术打印所述关节面假体模型以生成关节面假体；以金属、合金或高分子为源材料，采用3D技术打印所述距骨本体假体模型以生成距骨本体假体；
（5）将所述关节面假体放置在所述距骨本体假体的相应位置处，之后通过螺钉固定所述关节面假体和所述距骨本体假体，以形成距骨假体。
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