Establishment of a new method of digital orthopedic surgery and its widespread clinical applica-tion

丁煥文(Ding Huanwen，Dept Rehabil，Guangzhou Gen Hosp Guangzhou Mil Command，Guangzhou，Guangdong 510010)…∥Chin J Clin Basic Orthop Res.－2010，2(2).－92～97

Establishment of a new method of digital orthopedic surgery and its widespread clinical applica-tion

丁煥文(Ding Huanwen，Dept Rehabil，Guangzhou Gen Hosp Guangzhou Mil Command，Guangzhou，Guangdong 510010)…∥Chin J Clin Basic Orthop Res.－2010，2(2).－92～97

ObjectiveTo create an unique new method of digital orthopedic surgery and widely apply to spinal surgery，treatment of bone and joint injuries，ligament reconstruction and repair，bone minor resection and reconstruction，serious bone and joint malformation correction.This method can be used to investigate the clinical and surgical characteristics of digital orthopedic surgery by using a modem computer assisted processing and image analysis technique，therefore it can improve diagnosis and therapy level for orthopedic patients.MethodsAccording to fundamental principles of reverse engineering，2D bone images scanned by CT/MRI were gained，then 3D anatomic models of bone and joint were reconstituted with computer-aided technique which were then inputted into computer assisted design(CAD)software and analyzed exactly.Entities of bone and joint models were manufactured using rapid prototyping(RP)technique.Subsequently anatomic models were inputted into computer to carry out the disign and preoperative recearsal for surgical procedure，selection of suitable internal fixation materials，and the manufacturing of CAD-RP aided surgical templates and individualized implants.Eventually，orthopedic surgery was performed precisely.ResultsOne hundred and twenty-three orthopedic patients were treated by this methods and experiences were obtained in the following clinical digital orthopedic fields:1 computer-aided digital precise correction of bone and joint malformation.2 CAD-based individualized prosthesis of total knee，total hip，half pelvis.3 computer-aided reconstruction of anterior and posterior cruciate ligament.4.computer-aided prosthetic displancement in some special and difficult cases，such as prosthetic displacement or revision surgery for development dislocation of hip，total hip displacement for acetabular dysplasia with osteoarthritis.5.computeraided reduction and fixation for some special and difficult fractures，intra-articular fractures and neglected fractures.6.individualized resection design，structural and functional reconstruction of bone tumor.7.individualized orthopedic design and precise operation for scoliosis patients.8.individualized orthopedic design and precise operation for kyphosis patients.9.computer-aided reduction and fixation for treating odontoid bone fracture.10.computeraided operation design and exact pedicle screw placement for posterior atlantoaxial internal fixation.11.computeraided cervical pedicle shape analysis，measurement and accurate pedicle screw placement.ConclusionDepending on modern computer and advanced manufacturing techniques，orthopedic surgery can be performed precisely by the measures of CAD，bone and joint prototyping，computer assisted surgical design and rehearsal，individualized manufacturing of aided surgical templates，and bone defect implants，and then improve surgical safety and clinical effects.11 refs，1 fig.

(Authors)