CN113520620A - Navigation plate for personalized assisted coracoclavicular ligament complete anatomical reconstruction and manufacturing method - Google Patents
Navigation plate for personalized assisted coracoclavicular ligament complete anatomical reconstruction and manufacturing method Download PDFInfo
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- 210000003041 ligament Anatomy 0.000 title claims abstract description 111
- 238000004519 manufacturing process Methods 0.000 title claims abstract description 13
- 210000003109 clavicle Anatomy 0.000 claims abstract description 130
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 87
- 210000001991 scapula Anatomy 0.000 claims abstract description 33
- 238000000034 method Methods 0.000 claims abstract description 24
- 210000000142 acromioclavicular joint Anatomy 0.000 claims description 9
- 238000003780 insertion Methods 0.000 claims description 8
- 230000037431 insertion Effects 0.000 claims description 8
- 238000010146 3D printing Methods 0.000 claims description 3
- 230000008719 thickening Effects 0.000 claims description 3
- 238000009499 grossing Methods 0.000 claims description 2
- 238000005516 engineering process Methods 0.000 description 6
- 206010023204 Joint dislocation Diseases 0.000 description 4
- 210000003484 anatomy Anatomy 0.000 description 3
- 230000000694 effects Effects 0.000 description 2
- 208000002847 Surgical Wound Diseases 0.000 description 1
- 230000007012 clinical effect Effects 0.000 description 1
- 238000002591 computed tomography Methods 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
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- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1778—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the shoulder
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- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8897—Guide wires or guide pins
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- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
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Abstract
The invention relates to a navigation plate for personalized auxiliary coracoclavicular ligament complete anatomical reconstruction and a manufacturing method thereof, based on a base, each bone tunnel conduit is designed in a preset direction according to the central positions of an obliquity ligament and a taper ligament in a scapula coracoid process and a coracoid stop print, the process is obtained by combining and calculating anatomical marks in three-dimensional reconstruction software, the positions of two bundles of ligament of the obliquity ligament and the taper ligament can be ensured to completely accord with the anatomical positions, the direction of the tunnel is consistent with the designed direction, the accuracy and the safety of the operation are ensured, the obliquity ligament tunnel conduit and the taper ligament tunnel conduit are established on one base, the established tunnel is more accurate, in addition, the base is completely jointed with the bone surfaces of the clavicle and the coracoid process, the conduit marking the center position of the coracoid stop print and the direction of the bone tunnel is connected with the base into a whole, this enables the bone tunnel to be established without error.
Description
Technical Field
The invention relates to a navigation plate for personalized assisted coracoclavicular ligament complete anatomical reconstruction and a manufacturing method thereof, belonging to the technical field of medical instruments.
Background
The acromioclavicular joint dislocation is common in clinic, and the coracoid ligament reconstruction technology is widely applied to the treatment of the acromioclavicular joint dislocation at present, wherein the coracoid ligament consists of two ligaments, namely an orthorhombic ligament and a pyramidal ligament, and the two ligaments have different anatomical structures and functions. The currently common single-beam reconstruction technology is only approximate anatomical reconstruction of the clavicle insertion point, cannot completely replace the functions of the orthorhombic ligament and the pyramidal ligament, and the double-beam reconstructed coracoid clavicle ligament reported in a few reports is also not complete anatomical insertion point reconstruction. The coracoid clavicle ligament is reconstructed by completely dissecting the normal dissecting structures of the obliquity ligament and the pyramidal ligament respectively, so that the reconstructed biomechanical environment is closer to normal, and a better clinical effect is obtained. However, how to accurately obtain the orthorhombic ligament and the pyramidal ligament in the central area of the clavicle and the coracoid insertion point print and safely establish the bone tunnel in the operation puts higher demands on the technology of operators. In the operation, the central areas of the oblique ligament and the pyramidal ligament in the clavicle and the coracoid process dead center print are determined by using methods such as a ruler, an angle gauge and the like, and a bone tunnel is established, so that the accuracy and the precision are not high, and the success rate of the operation is influenced to a certain extent. Although the computer navigation technology can be accurately realized in an auxiliary way, the popularization degree of the navigation system is still not high, the price is high, and the coracoclavicular ligament complete anatomical reconstruction technology cannot be effectively applied and popularized in clinic, so that a new technology which can ensure the operation effect and does not depend on the navigation system is urgently needed.
Disclosure of Invention
The invention aims to provide a navigation board for personalized assistance of complete anatomy and reconstruction of coracoid clavicle, which can accurately and precisely acquire the central positions of the orthorhombic ligament and the pyramidal ligament in the coracoid process of the scapula, the dead center print of the clavicle and the bone tunnel direction, and improve the practical application efficiency.
The invention adopts the following technical scheme for solving the technical problems: the invention designs a navigation plate for personalized assistance of coracoclavicular ligament complete anatomy reconstruction, which comprises a coracoclavicular guide plate for assisting scapula coracoclavicular surface ligament reconstruction and a clavicle guide plate for assisting clavicle surface ligament reconstruction;
wherein the coracoid guide plate comprises a coracoid base, a first bone tunnel conduit and a second bone tunnel conduit, the first bone tunnel conduit and the second bone tunnel conduit penetrate through the surface of the coracoid base along the preset directions respectively and are used for reconstructing an orthorhombic ligament, the positions of the bone tunnel catheters on the coracoid base correspond to the central positions of the prints of corresponding ligaments on the coracoid insertion points of the scapulae respectively, the shapes and the sizes of the lower surfaces of the coracoid bases are matched with the shapes and the sizes of coracoid surfaces of the scapulae, the lower surfaces of the coracoid bases are used for being arranged on the bone surfaces of the coracoid processes of the scapulae, the end parts of the lower surfaces of the coracoid bases, which correspond to the lower surfaces of the coracoid bases respectively, under the first bone tunnel catheter and under the second bone tunnel catheter are parallel and level with the corresponding positions of the lower surfaces of the coracoid bases, and the end parts, which correspond to the upper surfaces of the coracoid bases respectively, on the first bone tunnel catheter and on the second bone tunnel catheter protrude by a first preset length on the upper surfaces of the coracoid bases.
As a preferred technical scheme of the invention: the clavicle guide plate comprises a clavicle base, a third bone tunnel conduit and a fourth bone tunnel conduit, wherein the third bone tunnel conduit and the fourth bone tunnel conduit penetrate through the surface of the clavicle base in each preset direction and are used for reconstructing an oblique ligament, the fourth bone tunnel conduit is used for reconstructing a pyramidal ligament, the position of each bone tunnel conduit on the clavicle base corresponds to the center position of a trace of a corresponding ligament at a clavicle stop point, the shape and the size of the lower surface of the clavicle base are matched with those of the clavicle surface, the lower surface of the clavicle base is used for being arranged on the clavicle surface, the end parts of the lower surface of the clavicle base, which correspond to the lower surface of the clavicle base, of the third bone tunnel conduit and the fourth bone tunnel conduit are parallel and level to the corresponding positions of the lower surface of the clavicle base, and the end parts, which correspond to the upper surface of the clavicle base, on the third bone tunnel conduit and the fourth bone tunnel conduit respectively protrude out of the upper surface of the clavicle base by a first preset length.
As a preferred technical scheme of the invention: the coracoid base and the clavicle base are respectively generated by the corresponding oblique square ligament and the pyramidal ligament reversely on the bone surface around the dead point print of the coracoid process or the clavicle of the corresponding scapula.
Correspondingly, the invention aims to provide a method for manufacturing a navigation plate for personalized assisted coracoid clavicle complete anatomical reconstruction, which can accurately and efficiently realize the construction of a designed navigation plate model and further realize the acquisition of the navigation plate.
The invention adopts the following technical scheme for solving the technical problems: the invention designs a manufacturing method of a navigation plate for personalized assisted coracoid clavicle complete anatomical reconstruction, which comprises the following steps:
step A, according to DICOM data of patient acromioclavicular joint bone tissues, obtaining surface three-dimensional models corresponding to the scapula surface and the clavicle surface respectively, and then entering step B;
b, determining the position information of an orthorhombic ligament and a pyramidal ligament in a three-dimensional model of the surface corresponding to the surface of the scapula and the surface of the clavicle respectively according to the center position of the stop print of the upper surface of the scapula and the center position of the stop print of the lower surface of the clavicle, and then entering the step C;
c, respectively executing stretching thickening operation aiming at surface three-dimensional models corresponding to the scapula surface and the clavicle surface and containing the position information of the obliquity ligament and the pyramidal ligament, obtaining a coracoid base model and a clavicle base model which accord with the target surface size and the target thickness, and then entering the step D;
d, respectively aiming at the coracoid base model and the clavicle base model, respectively constructing the axes of the bone tunnels corresponding to the corresponding orthorhombic ligament and the conic ligament in the base model according to the position information of the orthorhombic ligament and the conic ligament in the base model, respectively determining the positions of two first cylindrical end points on each axis, wherein the position of the first cylindrical end point on each axis corresponding to the upper surface of the base model protrudes out of the corresponding upper surface of the base model along the axis for a first preset length, the position of the first cylindrical end point on each axis corresponding to the lower surface of the base model is parallel to the corresponding position of the lower surface of the corresponding base model, respectively constructing a first cylinder with a preset first diameter along each axis according to the positions of the two first cylindrical end points on each axis, and then entering the step E;
step E, respectively constructing a hollow catheter for each first cylinder on the coracoid base model and the clavicle base model, namely forming a coracoid guide plate model and a clavicle guide plate model, and then entering step F;
and F, respectively constructing the coracoid guide plate and the clavicle guide plate according to the coracoid guide plate model and the clavicle guide plate model.
As a preferred technical solution of the present invention, the step E includes the following steps:
step E1, respectively determining two second cylindrical endpoint positions on each axis aiming at the coracoid base model and the clavicle base model based on the axes of the bone tunnels corresponding to the orthorhombic ligament and the pyramidal ligament in the base model respectively, wherein the second cylindrical endpoint position corresponding to the upper surface of the base model on each axis protrudes out of the upper surface of the corresponding base model along the axis by a second preset length, and the second cylindrical endpoint position corresponding to the lower surface of the base model on each axis is flush with the corresponding position of the lower surface of the corresponding base model, then respectively constructing a second cylinder with a preset second diameter along each axis according to the two second cylindrical endpoint positions on each axis, the second preset length is greater than the first preset length, and the second diameter is smaller than the first diameter, and then entering step E2;
step E2, aiming at the coracoid base model and the clavicle base model respectively, firstly, performing Boolean addition operation on a first cylinder on two axes in the base model and the base model to form a whole, then performing Boolean subtraction operation on the whole and the corresponding base model, and finally performing Boolean subtraction operation on the whole and a second cylinder on the two axes to obtain the hollow conduit on the two axes in the base model; namely, the coracoid guide plate model and the clavicle guide plate model are formed, and then the step F is carried out.
As a preferred technical scheme of the invention: in the step A, after surface three-dimensional models respectively corresponding to the surfaces of the scapula and the clavicle are obtained, the surfaces of the surface three-dimensional models are subjected to smoothing treatment and updated, and then the step B is carried out.
As a preferred technical scheme of the invention: and in the step F, constructing the coracoid guide plate and the clavicle guide plate respectively through a 3D printing mode according to the coracoid guide plate model and the clavicle guide plate model.
Compared with the prior art, the navigation plate for the personalized assisted coracoid clavicle complete anatomical reconstruction and the manufacturing method thereof have the following technical effects:
the invention designs a navigation plate for personalized auxiliary coracoid clavicle complete anatomical reconstruction and a manufacturing method thereof, based on a base, each bone tunnel conduit is designed in a preset direction according to the central positions of an obliquity ligament and a pyramidal ligament in a coracoid process and a clavicle dead center print of a scapula, the process is obtained by combining and calculating anatomical marks in three-dimensional reconstruction software, the two bundles of ligament positions of the obliquity ligament and the pyramidal ligament can be ensured to completely accord with anatomical positions, the direction of the tunnel is consistent with the designed direction, the accuracy and the safety of an operation are ensured, the obliquity ligament tunnel conduit and the pyramidal ligament tunnel conduit are established on the same base, the established tunnel is more accurate, in addition, the base is completely jointed with the bone surfaces of the clavicle and the coracoid process, the conduit marking the central position of the ligament dead center print and the direction of the bone tunnel is connected with the base, this enables the bone tunnel to be established without error.
Drawings
FIG. 1 is a schematic view of the structure of a coracoid guide plate in the design of the present invention;
FIG. 2 is a bottom view of the coracoid guide plate in the design of the present invention;
FIG. 3 is a schematic view of the coracoid guide plate in combination with the coracoid process of the scapula in the design of the present invention;
FIG. 4 is a schematic diagram of a clavicle guide plate design according to the invention;
FIG. 5 is a bottom view of the clavicle guide plate of the present invention;
FIG. 6 is a schematic view of the structure of the clavicle guide plate in combination with the clavicle in the design of the present invention;
fig. 7 is an overall schematic view of the coracoid guide plate in combination with the coracoid process of the scapula and the clavicle guide plate in combination with the clavicle in the design of the invention.
The bone tunnel catheter comprises a coracoid base 1, a first bone tunnel catheter 2, a second bone tunnel catheter 3, a clavicle base 4, a third bone tunnel catheter 5 and a fourth bone tunnel catheter 6.
Detailed Description
The following description will explain embodiments of the present invention in further detail with reference to the accompanying drawings.
The invention designs a navigation plate for personalized assistance of coracoclavicular ligament complete anatomical reconstruction, which comprises a coracoclavicular guide plate for assistance of scapula coracoid surface ligament reconstruction and a clavicle guide plate for assistance of clavicle surface ligament reconstruction.
In practical application, as shown in fig. 1 and 2, the coracoid guide plate includes a coracoid base 1, a first bone tunnel conduit 2 and a second bone tunnel conduit 3, wherein the first bone tunnel conduit 2 and the second bone tunnel conduit 3 penetrate through the surface of the coracoid base 1 in each preset direction to reconstruct an orthorhombic ligament, the second bone tunnel conduit 3 is used for reconstructing a pyramidal ligament, the position of each bone tunnel conduit on the coracoid base 1 corresponds to the center position of the imprint of the corresponding ligament at the coracoid insertion point of the scapula, the shape and the size of the lower surface of the coracoid base 1 are adapted to the shape and the size of the coracoid surface of the scapula, as shown in fig. 3, the lower surface of the coracoid base 1 is used for being arranged on the coracoid surface of the scapula, the end portions of the lower surface of the coracoid base 1, which respectively correspond to the lower surface of the coracoid base 1, under the first bone tunnel conduit 2 and the second bone tunnel conduit 3 are flush with the corresponding to the corresponding positions of the lower surface of the coracoid base 1, and the upper surface of the coracoid base 1 is provided with a first preset length.
As shown in fig. 4 and 5, the clavicle guide plate comprises a clavicle base 4, a third bone tunnel conduit 5 penetrating the surface of the clavicle base 4 in each preset direction for reconstructing an oblique ligament, a fourth bone tunnel conduit 6 for reconstructing a pyramidal ligament, the position of each bone tunnel conduit on the clavicle base 4 corresponds to the central position of the footprint of the corresponding ligament on the clavicle insertion point, the shape and the size of the lower surface of the clavicle base 4 are adapted to the shape and the size of the clavicle surface, as shown in fig. 6, the lower surface of the clavicle base 4 is configured to be disposed on the surface of the clavicle, the end portions of the lower surface of the clavicle base 4 corresponding to the lower surfaces of the third bone tunnel conduit 5 and the fourth bone tunnel conduit 6 are aligned with the corresponding positions of the lower surface of the clavicle base 4, respectively, and the end portions of the upper surface of the clavicle base 4 corresponding to the upper surfaces of the third bone tunnel conduit 5 and the fourth bone tunnel conduit 6 protrude from the upper surface of the clavicle base 4 by a first preset length.
In practical application, the coracoid base 1 and the clavicle base 4 are respectively generated by the corresponding oblique square ligament and the pyramidal ligament reversely on the bone surface around the dead point print of the coracoid process or the clavicle of the corresponding scapula.
In the actual manufacturing of the navigation board designed for the personalized assisted coracoid ligament complete anatomical reconstruction, CT scanning is performed on the acromioclavicular joint of a patient with acromioclavicular joint dislocation to obtain DICOM data of the acromioclavicular joint bone tissue of the patient, and then in the actual application, the following steps A to F are specifically performed.
Step A, according to DICOM data of patient acromioclavicular joint bone tissues, importing the DICOM data into three-dimensional reconstruction software MIMICS for editing to obtain surface three-dimensional models respectively corresponding to the scapula surface and the clavicle surface, then performing smooth processing and updating on the surfaces of the surface three-dimensional models, and then entering step B.
And step B, determining the position information of the oblique ligament and the pyramidal ligament in the surface three-dimensional model respectively corresponding to the scapula surface and the clavicle surface according to the center position of the dead point print of the scapula upper surface and the dead point print of the clavicle lower surface by using three-dimensional reconstruction software MIMICS, and then entering the step C.
And C, respectively aiming at the three-dimensional surface models which correspond to the surfaces of the scapula and the clavicle and contain the position information of the obliquity ligament and the pyramidal ligament, introducing 3-Matic software in an STL format to perform stretching and thickening operation, obtaining a coracoid base model and a clavicle base model which accord with the target surface size and the target thickness, stretching the surface of the three-dimensional surface model outwards by 5mm in practical application, forming the thickness of the coracoid base model and the clavicle base model which have specific sizes, and then entering the step D.
Step D, respectively aiming at the coracoid base model and the clavicle base model, establishing the axes of the bone tunnel corresponding to the corresponding orthorhombic ligament and the conic ligament respectively according to each preset direction based on the position information of the orthorhombic ligament and the conic ligament in the base model, respectively determining the position of two first cylindrical end points on each axis, wherein the position of the first cylindrical end point on each axis corresponding to the upper surface of the base model protrudes a first preset length along the axis, such as 10mm from the upper surface of the corresponding base model, and the position of the first cylindrical end point on each axis corresponding to the lower surface of the base model is flush with the corresponding position of the lower surface of the corresponding base model, then, according to the positions of two first cylinder end points on each axis, a first cylinder with a preset first diameter, such as 6mm, is constructed along each axis, and then step E is performed.
And E, respectively constructing a hollow catheter for each first cylinder on the coracoid base model and the clavicle base model, namely forming the coracoid guide plate model and the clavicle guide plate model, and then entering the step F.
In practical applications, the following steps E1 to E2 are specifically performed.
And E1, respectively determining the positions of two second cylindrical end points on each axis for the coracoid base model and the clavicle base model based on the axes of the bone tunnels corresponding to the orthorhombic ligament and the pyramidal ligament in the base model respectively, wherein the position of the second cylindrical end point on each axis corresponding to the upper surface of the base model protrudes out of the upper surface of the corresponding base model along the axis by a second preset length, such as 11mm, and the position of the second cylindrical end point on each axis corresponding to the lower surface of the base model is flush with the corresponding position of the lower surface of the corresponding base model, then respectively constructing a second cylinder with a preset second diameter, such as 3mm, along each axis according to the positions of the two second cylindrical end points on each axis, and then entering the step E2.
Step E2, aiming at the coracoid base model and the clavicle base model respectively, firstly, performing Boolean addition operation on a first cylinder on two axes in the base model and a corresponding base model to form a whole, then performing Boolean subtraction operation on the whole and the base model, and finally performing Boolean subtraction operation on the whole and a second cylinder on the two axes to obtain the hollow conduit on the two axes in the base model; namely, the coracoid guide plate model and the clavicle guide plate model are formed, and then the step F is carried out.
And F, respectively constructing the coracoid guide plate and the clavicle guide plate according to the coracoid guide plate model and the clavicle guide plate model in a 3D printing mode.
The navigation plate designed for the personalized assistance of the complete coracoid clavicle dissection reconstruction is applied to the practice, firstly, the surgical incision is consistent with the reconstruction mode of the coracoid clavicle ligament through traditional acromioclavicular joint dislocation incision and reduction, an arc incision is made to the coracoid process tip at a position which is about 30cm away from the distal end of the clavicle, the coracoid process is incised layer by layer, and the distal end of the clavicle and the bone surface of the coracoid process of the scapula are fully exposed; then, as shown in fig. 7, the design coracoid guide plate and the clavicle guide plate are respectively placed on the coracoid surface and the clavicle surface of the scapula, so as to ensure that the lower surface of the coracoid base in the coracoid guide plate is completely attached to the coracoid surface of the scapula and the lower surface of the clavicle base in the clavicle guide plate is completely attached to the clavicle surface; and finally, establishing a bone tunnel by using a Kirschner wire or a drill through the catheter, and completing routine operations such as ligament reconstruction and the like after the guide plate is taken down.
The navigation plate and the manufacturing method thereof are designed for the personalized assistance of the complete anatomical reconstruction of the coracoid clavicle, based on the base, each bone tunnel conduit is designed in the preset direction according to the central positions of the obliquity ligament and the taper ligament in the coracoid process and the coracoid cut point print of the scapula, the process is obtained by combining and calculating anatomical marks in three-dimensional reconstruction software, the positions of two bundles of ligament of the obliquity ligament and the taper ligament can be ensured to completely accord with the anatomical positions, the direction of the tunnel is consistent with the designed direction, the accuracy and the safety of the operation are ensured, the obliquity ligament tunnel conduit and the taper ligament tunnel conduit are established on one base, the established tunnel is more accurate, in addition, the base is completely jointed with the bone surfaces of the clavicle and the coracoid process, the central position of the mark ligament cut point print and the conduit in the bone tunnel direction are connected with the base into a whole, this enables the bone tunnel to be established without error.
The embodiments of the present invention have been described in detail with reference to the drawings, but the present invention is not limited to the above embodiments, and various changes can be made within the knowledge of those skilled in the art without departing from the gist of the present invention.
Claims (7)
1. A navigation plate for personalized assisted coracoid full anatomic reconstruction, characterized in that: comprises a coracoid guide plate for assisting shoulder blade coracoid surface ligament reconstruction and a clavicle guide plate for assisting clavicle surface ligament reconstruction;
wherein, the coracoid guide plate comprises a coracoid base (1), a first bone tunnel conduit (2) and a second bone tunnel conduit (3) which respectively penetrate through the surface of the coracoid base (1) according to each preset direction and are used for reconstructing an oblique ligament, the position of each bone tunnel conduit on the coracoid base (1) respectively corresponds to the imprint center position of a corresponding ligament at the coracoid insertion point of the scapula, the shape and the size of the lower surface of the coracoid base (1) are matched with the shape and the size of the coracoid surface of the scapula, the lower surface of the coracoid base (1) is used for being arranged on the bone surface of the coracoid, the end parts which respectively correspond to the lower surface of the coracoid base (1) under the first bone tunnel conduit (2) and the second bone tunnel conduit (3) are parallel and level with the corresponding position of the lower surface of the coracoid base (1), the end parts which respectively correspond to the upper surface of the coracoid base (1) on the first bone tunnel conduit (2) and the second bone tunnel conduit (3) 1) The upper surface has a first predetermined length.
2. A navigation plate for personalized assisted coracoid full anatomic reconstruction according to claim 1, characterized in that: the clavicle guide plate comprises a clavicle base (4), a third bone tunnel conduit (5) and a fourth bone tunnel conduit (6), wherein the third bone tunnel conduit (5) and the fourth bone tunnel conduit (6) penetrate through the surface of the clavicle base (4) according to preset directions and are used for reconstructing an oblique ligament, the position of each bone tunnel conduit on the clavicle base (4) corresponds to the center of a mark of a corresponding ligament at a clavicle insertion point, the shape and the size of the lower surface of the clavicle base (4) are matched with those of a clavicle surface, the lower surface of the clavicle base (4) is used for being arranged on the clavicle surface, the end part of the lower surface of the clavicle base (4) corresponding to the lower surface of the clavicle base (4) under the third bone tunnel conduit (5) and the fourth bone tunnel conduit (6) are parallel and level with the corresponding position of the lower surface of the clavicle base (4), the upper surface of the end part of the clavicle base (4) corresponding to the upper surface on the third bone tunnel conduit (5) and the fourth bone tunnel conduit (6) are respectively in a first preset length And (4) degree.
3. A navigation plate for personalized assisted coracoid full anatomic reconstruction according to claim 2, characterized in that: the coracoid base (1) and the clavicle base (4) are respectively generated by the corresponding oblique square ligament and the pyramidal ligament reversely on the bone surface around the dead point print of the coracoid process or the clavicle of the corresponding scapula.
4. A method for making a navigation plate for personalized assisted coracoid clavicular ligament complete anatomical reconstruction according to any one of claims 1 to 3, characterized in that it comprises the following steps:
step A, according to DICOM data of patient acromioclavicular joint bone tissues, obtaining surface three-dimensional models corresponding to the scapula surface and the clavicle surface respectively, and then entering step B;
b, determining the position information of an orthorhombic ligament and a pyramidal ligament in a three-dimensional model of the surface corresponding to the surface of the scapula and the surface of the clavicle respectively according to the center position of the stop print of the upper surface of the scapula and the center position of the stop print of the lower surface of the clavicle, and then entering the step C;
c, respectively executing stretching thickening operation aiming at surface three-dimensional models corresponding to the scapula surface and the clavicle surface and containing the position information of the obliquity ligament and the pyramidal ligament, obtaining a coracoid base model and a clavicle base model which accord with the target surface size and the target thickness, and then entering the step D;
d, respectively aiming at the coracoid base model and the clavicle base model, respectively constructing the axes of the bone tunnels corresponding to the corresponding orthorhombic ligament and the conic ligament in the base model according to the position information of the orthorhombic ligament and the conic ligament in the base model, respectively determining the positions of two first cylindrical end points on each axis, wherein the position of the first cylindrical end point on each axis corresponding to the upper surface of the base model protrudes out of the corresponding upper surface of the base model along the axis for a first preset length, the position of the first cylindrical end point on each axis corresponding to the lower surface of the base model is parallel to the corresponding position of the lower surface of the corresponding base model, respectively constructing a first cylinder with a preset first diameter along each axis according to the positions of the two first cylindrical end points on each axis, and then entering the step E;
step E, respectively constructing a hollow catheter for each first cylinder on the coracoid base model and the clavicle base model, namely forming a coracoid guide plate model and a clavicle guide plate model, and then entering step F;
and F, respectively constructing the coracoid guide plate and the clavicle guide plate according to the coracoid guide plate model and the clavicle guide plate model.
5. Method for the production of a navigation plate for the personalised assisted coracoid complete anatomical reconstruction, according to claim 4, characterized in that said step E comprises the following steps:
step E1, respectively determining two second cylindrical endpoint positions on each axis aiming at the coracoid base model and the clavicle base model based on the axes of the bone tunnels corresponding to the orthorhombic ligament and the pyramidal ligament in the base model respectively, wherein the second cylindrical endpoint position corresponding to the upper surface of the base model on each axis protrudes out of the upper surface of the corresponding base model along the axis by a second preset length, and the second cylindrical endpoint position corresponding to the lower surface of the base model on each axis is flush with the corresponding position of the lower surface of the corresponding base model, then respectively constructing a second cylinder with a preset second diameter along each axis according to the two second cylindrical endpoint positions on each axis, the second preset length is greater than the first preset length, and the second diameter is smaller than the first diameter, and then entering step E2;
step E2, aiming at the coracoid base model and the clavicle base model respectively, firstly, performing Boolean addition operation on a first cylinder on two axes in the base model and the base model to form a whole, then performing Boolean subtraction operation on the whole and the corresponding base model, and finally performing Boolean subtraction operation on the whole and a second cylinder on the two axes to obtain the hollow conduit on the two axes in the base model; namely, the coracoid guide plate model and the clavicle guide plate model are formed, and then the step F is carried out.
6. Method of making a navigation plate for personalized assisted coracoid clavicular ligament complete anatomical reconstruction according to claim 4, characterized in that: in the step A, after surface three-dimensional models respectively corresponding to the surfaces of the scapula and the clavicle are obtained, the surfaces of the surface three-dimensional models are subjected to smoothing treatment and updated, and then the step B is carried out.
7. Method of making a navigation plate for personalized assisted coracoid clavicular ligament complete anatomical reconstruction according to claim 4, characterized in that: and in the step F, constructing the coracoid guide plate and the clavicle guide plate respectively through a 3D printing mode according to the coracoid guide plate model and the clavicle guide plate model.
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109480955A (en) * | 2018-12-19 | 2019-03-19 | 常州市第人民医院 | Operation guide plate in coracoclavicular ligament reconstruction and preparation method thereof |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109480955A (en) * | 2018-12-19 | 2019-03-19 | 常州市第人民医院 | Operation guide plate in coracoclavicular ligament reconstruction and preparation method thereof |
Non-Patent Citations (1)
| Title |
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| 孙伟等: "喙锁韧带解剖重建治疗肩锁关节脱位的初步研究", 《中国矫形外科杂志》 * |
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