Study on secure tunnel in the fixation of talar neck fracture based on digital technology
10.3760/cma.j.issn.0253-2352.2014.05.011
- VernacularTitle:基于数字化技术建立距骨颈骨折螺钉固定安全通道的研究
- Author:
Xi ZHANG
;
Jinquan HE
;
Yanxi CHEN
;
Yongcheng HU
- Publication Type:Journal Article
- Keywords:
Talus;
Fractures,bone;
Internal Fixators;
Computers,analog
- From:
Chinese Journal of Orthopaedics
2014;34(5):572-581
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the establishment of secure tunnel in fixation for the talar neck fracture when screws were fixed from the medial wall of talus.Methods The age of volunteers was limited from 20 to 60 years old,and the height of male volunteers was from 165 to 185 centimeters,while the female volunteers' height was from 155 to 175 centimeters.The body mass index (BMI) was less than 25.The volunteers who were not heavy manual workers or standing working for long time had no history of ankle or foot fractures,and there were no evidence of degeneration changes in ankle joints according to X-ray.At last there were 33 males in this study with an average age of 43.7 (21-59) years and an average height of 176.0 (168-184) centimeters.There were 22 females with an average age of 43.2 (22-60) years and an average height of 165.4 (158-172) centimeters.After the volunteers' ankle joints and feet were scanned by CT,the reconstructed images were stored in CD and the slice thickness was 0.75 millimeters.The SuperImageTM Orthopedics Edition1.1 software was used to display the images and perform three dimensional reconstruction.The height of talar neck and the height of tarsal canal were measured.The models that screws passing into tarsal canals were built.The maximal length and angle that screws were inserted in the middle 1/3 and in the inferior 1/3 of medial wall of talus and run along to two directions were measured.At last,the data were analyzed with SPSS 13.0 software.Results The height of talar neck and tarsal canal had no significant difference between left side and right side in the same gender.The height of male talar neck was greater than the female' s.The models of screws passing into tarsal canals was gained.The length and angle in different insert points and different directions of screw fixation were also gained.When the screws were inserted from the middle 1/ 3 of the medial wall of talus,the angle of screw fixation was much wider than that when the screws were inserted from the inferior 1/ 3 of the medial wall of talus.At last,the safe range of the length and angel of screw fixation was calculated.Conclusion Damage of the blood of talus during internal fixation should be avoided.The middle 1/3 of the medial wall of talus is the most favourable choice to the fixation.Combining the digital technology with internal fixation for talar neck fracture could promote the operation' s security and feasibility.
