傳統的骨科手術,醫師是藉由病患骨骼的X光照片或斷層掃描(CT)影像,而雖然電腦斷層掃瞄可以提供精準的3D模型,但成本較貴,以本身的醫學解剖知識與臨床手術經驗來進行術前規劃。由於平面影像不易產生空間感,手術進行中也缺乏精確的器械導引輔助,難以精準的依據術前規劃之路徑進行操作,手術品質因而不易掌握。本研究旨在利用X光片重建之完整膝關節三維幾何模型,獲得人體膝關節三維的資料,來構成全人工膝關節置換手術所需的切除路徑及邊界,以輔助醫師做術前的規劃與演練。 我們以Borland C++ Builder 6.0為開發環境,使用OpenGL graph library輔助畫面呈現。本研究是透過在X片上選取足以描述膝關節外型的特徵,並以一個CT作為樣版,建構出客制化的三維模型,然後在所建構的3D模型上,進行術前規劃,獲得所需要選擇的人工膝關節大小,進而得知切除路徑和邊界。
In orthopedics, conventional treatments often retrieve images from either X-ray or Computer Tomography (CT) for surgical planning, and then precede surgical operation with those information and experiences. Since three dimensional models can not be represented adequately by two dimensional images, also, the lack of precise mechanism for guiding during surgical operation result in imprecise motions even though the surgical planning is accurate enough. Thus the quality of operation is not confidential for doctors. This research aims to develop a software system in using STL by CT reconstruction, which to gain data of knee to build boundary of total knee replacement, in order to assist orthopedist in proceeding 3-D surgical planning and simulation of osteotomy. The software is developed in Borland C++ Builder 6.0, and OpenGL library as the tool for graphical presentation of this system. We extracted the features for describing the outline of the knee joint through x-ray images and adopted a CT image as our standard template to customize all size of knee models. And then we apply our three dimensional model for surgical planning so as to acquire and select the size of the knee implant, cutting path and borders for replacement surgery.
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