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Proper fixation techniques are crucial in orthopedic surgery for the treatment of various medical conditions. Fractures of the distal humerus can occur due to either high-energy trauma with skin rupture or low-energy trauma in osteoporotic bone. The recommended surgical approach for treating these extra-articular distal humerus fractures involves performing an open reduction and internal fixation procedure using plate implants. This surgical intervention plays a crucial role in enhancing patient recovery and minimizing soft tissue complications. Dynamic Compression Plates (DCPs) and Locking Compression Plates (LCPs) are commonly used for bone fixation, with LCP extra-articular distal humerus plates being the preferred choice for extra-articular fractures. These fixation systems have anatomically shaped designs that provide angular stability to the bone. However, depending on the shape and position of the bone fracture, additional plate bending may be required during surgery. This can pose challenges such as increased surgery time and the risk of incorrect plate shaping. To enhance the accuracy of plate placement, the study introduces the Method of Anatomical Features (MAF) in conjunction with the Characteristic Product Features methodology (CPF). The utilization of the MAF enables the development of a parametric model for the contact surface between the plate and the humerus. This model is created using specialized Referential Geometrical Entities (RGEs), Constitutive Geometrical Entities (CGEs), and Regions of Interest (ROI) that are specific to the human humerus bone. By utilizing this anatomically tailored contact surface model, the standard plate model can be customized (bent) to precisely conform to the distinct shape of the patient's humerus bone during the pre-operative planning phase. Alternatively, the newly designed model can be fabricated using a specific manufacturing technology. This approach aims to improve geometrical accuracy of plate fixation, thus optimizing surgical outcomes and patient recovery.
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This study investigates the impact of annealing time, temperature, and layer height on the tensile strength and dimensional change of three 3D printing materials (PLA, PETG, and carbon fiber-reinforced PETG). Samples with varying layer heights (0.1 mm, 0.2 mm, and 0.3 mm) were annealed at temperatures ranging from 60-100 °C for 30, 60, and 90 min. Tensile tests were conducted, and regression models were developed to analyze the effects of these parameters on tensile strength. The models exhibited high accuracy, with a maximum deviation of only 5% from measured validation values. The models showed that layer height has a significantly bigger influence on tensile strength than annealing time and temperature. Optimal combinations of parameters were identified for each material, with PLA performing best at 0.1 mm/60 min/90 °C and PETG and PETGCF achieving optimal tensile strength at 0.1 mm/90 min/60 °C. PETGCF demonstrated smallest dimensional change after annealing and had the best modulus of elasticity of all the materials. The study employed experimental testing and regression models to assess the results across multiple materials under consistent conditions, contributing valuable insights to the ongoing discussion on the influence of annealing in 3D-printed parts.
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Computer-Assisted Orthopaedic Surgery (CAOS) defines a set of techniques that use computers and other devices for planning, guiding, and performing surgical interventions. The important components of CAOS are accurate geometrical models of human bones and plate implants, which can be used in preoperational planning or for surgical guiding during an intervention. Software framework which is introduced in this study is based on the Model-View-Controller (MVC) architectural pattern, and it uses 3D models of bones and plate implants developed by the application of the Method of Anatomical Features (MAF). The presented framework may be used for preoperative planning processes and for the production of personalized plate implants. The main idea of the research was to develop a novel integrated software framework which will provide improved personalized healthcare to the patient, and at the same time, provide the surgeon with more control over the patient's treatment and recovery.
Assuntos
Transplante Ósseo/métodos , Próteses e Implantes , Software , Cirurgia Assistida por Computador/métodos , Adolescente , Algoritmos , Placas Ósseas , Humanos , Imageamento Tridimensional , Masculino , Mandíbula/diagnóstico por imagem , Modelos Anatômicos , Modelos Teóricos , Cirurgia Assistida por Computador/instrumentação , Tíbia/diagnóstico por imagemRESUMO
Geometrically accurate and anatomically correct 3D models of the human bones are of great importance for medical research and practice in orthopedics and surgery. These geometrical models can be created by the use of techniques which can be based on input geometrical data acquired from volumetric methods of scanning (e.g., Computed Tomography (CT)) or on the 2D images (e.g., X-ray). Geometrical models of human bones created in such way can be applied for education of medical practitioners, preoperative planning, etc. In cases when geometrical data about the human bone is incomplete (e.g., fractures), it may be necessary to create its complete geometrical model. The possible solution for this problem is the application of parametric models. The geometry of these models can be changed and adapted to the specific patient based on the values of parameters acquired from medical images (e.g., X-ray). In this paper, Method of Anatomical Features (MAF) which enables creation of geometrically precise and anatomically accurate geometrical models of the human bones is implemented for the creation of the parametric model of the Human Mandible Coronoid Process (HMCP). The obtained results about geometrical accuracy of the model are quite satisfactory, as it is stated by the medical practitioners and confirmed in the literature.
Assuntos
Mandíbula/anatomia & histologia , Modelos Anatômicos , Biologia Computacional , Simulação por Computador , Humanos , Imageamento Tridimensional/métodos , Imageamento Tridimensional/estatística & dados numéricos , Mandíbula/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
The paper presents a case where an implant for a part of the sternum (with costal cartilages) affected by cancer was created and implanted by using the specific reverse modeling method and solid free-form fabrication. The method provides surgeons with a fast and reliable tool for tissue engineering and implantation and therefore improves the quality of life for patients. Digital images of healthy sternum samples were used to develop a reverse modeling algorithm that semi-automatically generates a necessary and sufficient simplification of the tissue geometry to be fabricated in an inexpensive and applicable manner. In this particular case, the redesign of the missing part of the sternum in CAD software took three designer-hours. At the same time, the suitable simplification of the geometry affects the fabrication of simpler and less expensive casting molds. Furthermore, the core of the developed algorithm for the reverse modeling of sternum can be applied in the reverse modeling improvement of other tile (or plate-like) bones.