Intraoperative cone-beam CT for correction of periaxial malrotation of the femoral shaft: A surface-matching approach
Intraoperative cone-beam CT for correction of periaxial malrotation of the femoral shaft: A surface-matching approach
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DOI：
10.1118/1.2710330
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发表时间：
2007-04-01
期刊：
影响因子：
3.8
通讯作者：
Jaffray, David
中科院分区：
文献类型：
--
作者：
Khoury, Amal;Whyne, Cari M.;Jaffray, David
在股骨干骨折中，肢体长度、对齐和旋转可能很难确定。术中评估轴旋转特别困难。股骨错位可导致畸形、疼痛和继发性退行性关节损伤。本研究的目的是开发一种基于锥形束计算机断层扫描（CBCT）的术中方法来指导股骨干骨折的对准。我们假设骨表面匹配可以预测旋转不良，即使是严重粉碎。对尸体股骨进行了 16 个股骨轴周旋转不良（-51.2 度至 60.1 度）的成像。对图像进行处理，得到由脊和谷图案组成的未包裹的骨表面图。通过移除中线 CT 切片来模拟骨折间隙。通过将现有的近端和远端碎片外推至骨折的中线来重建间隙。然后移动两个骨表面以对齐骨特征。使用表面匹配准确评估轴周旋转不良（r（2）= 0.99，斜率1.0）。最大平均误差为2.20度，重复测量的平均差异为0.49度。 CBCT可以提供大视野的术中高分辨率图像。这种成像质量使得即使在大面积粉碎的情况下也可以使用表面匹配算法。 (c) 2007 年美国医学物理学家协会。
Limb length, alignment and rotation can be difficult to determine in femoral shaft fractures. Shaft axis rotation is particularly difficult to assess intraoperatively. Femoral malpositioning can cause deformity, pain and secondary degenerative joint damage. The aim of this study is to develop an intraoperative method based on cone-beam computed tomography (CBCT) to guide alignment of femoral shaft fractures. We hypothesize that bone surface matching can predict malrotation even with severe comminution. A cadaveric femur was imaged at 16 femoral periaxial malrotations (-51.2 degrees to 60.1 degrees). The images were processed resulting in an unwrapped bone surface plot consisting of a pattern of ridges and valleys. Fracture gaps were simulated by removing midline CT slices. The gaps were reconstituted by extrapolating the existing proximal and distal fragments to the midline of the fracture. The two bone surfaces were then shifted to align bony features. Periaxial malrotation was accurately assessed using surface matching (r(2) = 0.99, slope 1.0). The largest mean error was 2.20 degrees and the average difference between repeated measurements was 0.49 degrees. CBCT can provide intraoperative high-resolution images with a large field of view. This quality of imaging enables surface matching algorithms to be utilized even with large areas of comminution. (c) 2007 American Association of Physicists in Medicine.