基于计算生物力学测试模式的踝关节骨折病理力学机制研究

The program focuses on ankle fractures, which are complicated, with a high morbidity. Based on the previous related research, the program host further expands the "digital orthopedics platform for clinical research (SuperImage)" system, which has the international advanced level. The system is combined with finite element analysis software to generate rapidly a three dimensional finite element model of ankle and its nearby ligament structures through 3D image segmentation techniques, automatic grid optimized mode and intelligentized model material given techniques. The model is used to simulate different loading conditions and is validated by the biomechanical loading test of the fresh cadaver foot specimen. The program applies the new and rapid finite element modeling method and is combined with digital 3D measurement technology and virtual surgical techniques. It is based on the computational biomechanical research pattern to analyze the slight relationship between morphological characteristics and pathological mechanical changes in more than 200 ankle fracture cases and to filter and prove the best internal fixation solution. The achievement of the research will provide a series of precise and reliable pathological mechanical parameters in treating the peri-ankle trauma, thereby an objective pathological mechanical theory evidence can be provided for the classification of the peri-ankle fractures, the choice of the treatment and the assessment of the surgical curative effect. In addition, this research can also demonstrate and promote the efficient computational biomechanical research pattern based on the intelligent digital medical research platform to be widely used in the whole body bone and joint disease related research.

本项目针对踝关节骨折的高发病率及复杂性，在申请者前期工作基础上，深入拓展具有国际领先水平的"数字化骨科临床研究平台（SuperImage系统）"结合有限元分析软件，通过三维图像分割技术、自动网格优化模式、智能化模型材质赋予，快速生成踝关节及其周围韧带结构的三维有限元模型并模拟加载分析；通过新鲜尸体足标本的生物力学加载测试对新构建的有限元建模技术进行有效性验证；通过计算生物力学研究模式，应用新一代快速有限元建模分析解决方案结合数字化组合式三维测量技术及虚拟手术技术，深入剖析200例以上的踝关节骨折形态学特征与病理力学变化的细微关系及筛选与论证最佳内固定治疗方案。研究目标的实现可为踝关节骨折分型、手术指征确定、治疗方案选择、手术疗效评估提供一项科学、客观的病理力学理论依据。同时，本研究还可论证和推动基于智能化数字医学研究平台的高效计算生物力学研究模式在全身骨与关节疾病相关研究中的广泛应用。

本项目针对踝关节周围创伤的高发病率及复杂性，应用基于CT图像后处理技术的"数字化骨科临床研究平台（SuperImage）"系统，创建了本研究专用的Mini PACS系统和高分辨率的内置入物模型数据库，完成了大样本踝关节影像学原始数据的收集。在研究技术上，通过三维空间点、线、平面、曲面，四元素相结合的组合式三维测量技术，构建出了一套客观、精准、可重复性的踝关节周围骨性结构三维解剖形态学测量技术。在研究结果上，完成了对内踝置钉技术相关的解剖学测量；论证了CT三维重建技术在踝关节骨折术后评估中的应用价值；论证了后踝骨折的三维形态学特征与临床疗效的相关性。本研究结果为进一步阐明踝关节骨折病理力学机制的临床意义打下坚实的基础，为踝关节骨折分型、手术指征确定、治疗方案选择、手术疗效评估提供一项科学、客观的理论依据。

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