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管国平* guanguoping 南京医科大学附属江宁医院 the Jiangning affiliated hospital of Nanjing medical university guanguoping2003@163.com 
蒋旭 jianxu 南京医科大学附属江宁医院骨二科  
易进 yijin 南京医科大学附属江宁医院骨二科  
王超 wangchao 南京医科大学附属江宁医院骨二科  
中文摘要:目的: 探讨Mimics辅助虚拟复位个体化辅助PFNA内固定治疗外侧壁不稳定型股骨粗隆间骨折的疗效。方法: 回顾性分析2015年1月至2018年6月收治的不稳定性外侧壁损伤的股骨粗隆间骨折的患者资料,本组11组,本组男3例,女8例,年龄64-81岁,平均73.7±6.5岁。根据AO分型,A3.1型3例、A3.2型6例、A3.3型2例,所有病人均作CT扫描,根据CT扫描数剧,采用Mimics重建三维重建骨折,先进行虚拟复位,复位满意后,模拟置入PFNA。根据外侧壁骨折特征与拉力螺钉尾在外侧壁的位置关系,采用PFNA+钛缆或钢丝4例,PFNA+重建锁定钢板7例。通过术后随访评估骨折复位质量及愈合情况,最后一次复查髋关节Harris评分。结果: 本组11例病人获得随访,术后均获得了良好的复位,无术后切口感染,无内固定松动,骨折均愈合,愈合时间12-20周,平均愈合时间16.4±3.3周,末次随访时采用髋关节Harris评分,优6例,良3,可2例。结论: 采用Mimics辅助虚拟复位个体化辅助PFNA固定治疗股骨粗隆间骨折,有助于术前计划,能提高手术疗效。
【关键词】髋骨折  骨折固定术,内  Mimics 软件
Virtual reduction and personalized additional fixation in treatment of unstable external wall type intertrochanteric fracture with proximal femoral nail antirotation(PFNA) by Mimics software
ABSTRACT  ABSTRACT Objective: To investigate the clinical outcome of virtual reduction and personalized additional fixation in treatment of unstable external wall type intertrochanteric fracture with proximal femoral nail antirotation (PFNA) by Mimics software. Methods: From Jan 2015- Jun 2018, 11 patients of unstable lateral wall type intertrochanteric were retrospectively analyzed. Among them, 3 cases were male and 8 were female, the average age of from 73.76.5 years old, ranged from 64 to 81years. According to AO type classification, there were 3 cases of type A3.1, 6 case of type A3.2, and 2 cases of type A3.3. All patients receiving CT tomography, Three-dimensional models of proximal femur were reconstructed, fracture model was simulate operation reset, PFNA was assembled with Mimics software. According to relationship between the lateral wall fracture morphological features and the position of nail on the lateral wall, 4 cases were treated by PFNA with Titanic cable or steel wire .7 cases by PFNA with Reconstructive locking plate. The fracture reduction quality, and fracture healing quality were assessed by the postoperative follow - up review, Harris score was evaluated in last follow—up.Results: All patients were followed up , The fracture reduction quality is good or excellent , Bone healing time was ranged from12 weeks to 20weeks ,with an average 16.43.3 weeks , According to Harris function score: 6 cases were excellent; 3 cases good; 2 cases fair ; there is one case of lower extremity deep vein thrombosis, but no complication of incisions infection and breakage or cut-out of internal instrument .Conclusions: Virtual reproduction and PFNA combined with personalized additional fixationin in treatment of unstable external wall type intertrochanteric fractur by Mimics which is helpful to make preoperative operation planning ,and can improve surgical efficacy
KEY WORDS  Hip frcatures  Fracture fixation,internal  Mimics soft
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