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Establishment and Application of Digitization Simulation Platform of Clinical Anatomy on Fracture of Articulatio Sacroiliaca

Author: SongLei
Tutor: ZhongShiZhen
School: First Military Medical University
Course: Clinical Anatomy
Keywords: Articulatio sacroiliaca Fracture Spiral computer tomography Electronic computer scanning Simulation Modeling Virtual reality
CLC: R319
Type: PhD thesis
Year: 2007
Downloads: 131
Quote: 1
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Pelvic fracture is a common serious damage in trauma. Along with rapid development of modern transportation, coal mine excavation, high-rise construction, the proportion of fracture of articulatio sacroiliaca in the serious damage also rise year by year. Because of the diversity of injured reasons and complex anatomical position, the serious damage of articulatio sacroiliaca, often is accompanied by many serious associated injuries, for example, the massive hemorrhage, the pelvic cavity internal organs damage and so on, and the mortality rate is high. Pelvic fracture without serious complications, in particular fracture of pelvic front ring, formerly be treated with the non-surgery conservative treatments, but which always has a bad outcome because of different reasons. Diagnoses about complicated pelvic fracture especially sacroiliac joint damage accompanied is local. Development of CT made the precisely diagnoses and intimate treatment plan possible. CT has become a important diagnoses method in the complicated pelvic fracture. Spiral volumetric CT three-dimensional reconstruction has been applicated in clinic. Circuitation cutting technique in Spiral volumetric CT can observe the fracture three-dimensional. It is important in the diagnoses of pelvic fracture. Rapid prototyping (RP) is a new technic developed in American during later period of 1980’s. RP can manufacture the prototype ofobject by CAD models or CT/MRI date controlled by compute. RP technic comprise Machinery mechanic, CAD, laser processing and numerical control technic, can manufacture experiment models rapidly and automated. RP is a process of demix and general, controlled by compute. It is useful in manufacture complex human organ. Rapid prototyping can manufacture any type organ models controlled by computer, and applicated in clinical diagnoses and education. Clinic is the major area of RP application in Europe. Doctor can make plan of operation according three-dimensional view and RP technic. Accurate models can guide the operation method and choice of internal fixation device. Prognosis can be identify. Long-term manufacture and expensive spend are the important problem of RP technic hinder its clinical application. Another problem is the radiating spokes suffered by doctor and patient in the process of CT guide. The model can be used once. Analogue technic based on simulate principle, information technology(IT) and system technic etc. It’s a technic about describe and a method about quantitative analysis. Doctor make operation decision according to the results of quantitative analysis by computer simulation. Analogue technics can solve a lot of problems in engineering and technology. The direction and plan of engineering can be checked by analogue technics. We can modify our plan if it doesn’t satisfy the expectant requests in time. Analogue technics can be used in many process includes choice of assembly and design of the system or engineering. Doctor can modify the accurate models of the fracture of patients according CT or MRI view by computer simulation. It is the base of diagnosis and treatment. The recent viewpoint believed that, regarding the unstable pelvic fracture, the conservative treatment was difficult to get a precise reposition. For restoring the health, reducing the mortality rate and disabled rate, the majority scholars and clinician advocated surgical treatments. Because of the complex structure of pelvis, the explicit phantom study examination, in front of the accurate diagnosis and the technique surgery simulation, has the important value in diagnosis and treatment on fracture of articulatio sacroiliaca. This research discusses the diagnosis and treatment of fracture of articulatio sacroiliaca, on the basis of successful establishment of clinical anatomy digitization simulation model platform for individual articulatio sacroiliaca fracture.First part: Establishment of clinical anatomy digitization simulation model platform for individual articulatio sacroiliaca fracture and related research.Objective.1. establishment of digitized simulation model platform for individual articulatio sacroiliaca fracture.2. Carrying on the analysis using the digitized simulation platform for individual cases data: evaluation of different diagnosis methods for articulatio sacroiliaca fracture, as well as the individual clinical operative design before the operation; providing the useful informations for the clinical diagnosis and treatment. Methods: 15 cases of preservative adult pelvis specimens, 160~179 cm height, 32~78 year old, average 50 years old, no osseous pathological changes such as abnormalities, tumor and fracture. All pelvis specimens were performed X-ray and CT examination, as well as image reconstruction after scanning. The digitized simulation modeling of data was completed, and the comparison was performed between diagnose accordance rates of different diagnosis methods. Results: According to the establishment of individual digitized simulation model platform, difference of diagnose accordance rates between different diagnosis methods can be well evaluated; and the preoperative simulation can be carried out according to different data on the computer, to formulate more reasonable operative treatment plan.Second part: Clinical anatomical verification of digitized simulation model platform for individual articulatio sacroiliaca fracture and the simulated effect of operation on corpse specimen. Objective: comparison of effects of operative simulation with digitized simulation model platform for individual articulatio sacroiliaca fracture and with corpse specimen, and comparison of effects of guiding clinical practice. Methods: 1. operative simulation for articulatio sacroiliaca fracture on preservative adult pelvis specimens; 2. operative simulation on digitized simulation model platform for individual articulatio sacroiliaca fracture, hypothesized stimulated operative model same as the real situation of individual data; 3. performing the comparison between two; Results: the use of digitized simulation model platform for individual articulatio sacroiliaca fracture on preoperative diagnosis and operative simulation, can obtain the satisfactory effect. Conclusions: 1. The establishment of clinical anatomy digitized simulation model platform for individual articulatio sacroiliaca fracture, may have a good use on the diagnosis and operative simulation for different state of injury simulated models; 2. digitized simulation model platform for individual articulatio sacroiliaca fracture can stimulate the injury state of articulatio sacroiliaca accurately and assists to formulate the operative treatment plan, which is satisfied on the confirmation effect, and can provide exhaustive reference for the clinical treatments.

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