[Design and preliminary clinical application of a new digitalized navigation template for fixation of the inferior tibiofibular joint].

ABSTRACT

OBJECTIVE: To design and prepare a new digitalized navigation template for fixation of inferior tibiofibular joint using three-dimensional reconstruction and reverse engineering techniques. METHODS: Five patients with inferior tibiofibular joint rupture without fibula fracture underwent three-dimensional CT scanning of the lower limbs. The image data were transferred into Mimics software, and after reconstruction of the three-dimensional models of inferior tibiofibular joint rupture and saving in .stl format, the three-dimensional models were imported into Imageware10.0 software to determine the three-dimensional plane of reference. The location of the optimal pedicle channel was defined using reverse engineering and AO internal fixation principle. The template was designed according to the anatomic features of the fibular surface, and the optimal pedicle channel and the template were overlapped as the navigational template, which was manufactured by rapid prototyping. The inferior tibiofibular joint was reduced and the template was placed distally on the external fibula, and the location for screw insertion was defined by the navigation template. RESULTS AND CONCLUSION: The digitalized model of the inferior tibiofibular joint was established. The navigation template manufactured offered good compatibility and was applied successfully for fixation of the inferior tibiofibular joint. This approach provides a new means for fixation of ruptured inferior tibiofibular joint using the reverse engineering and digitized 3-dimensional reconstruction techniques.