電腦輔助骨盆骨折術前規劃系統發展

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姓名

胡育昇(Yu-sheng Hu) 查詢紙本館藏

畢業系所

機械工程學系

論文名稱

電腦輔助骨盆骨折術前規劃系統發展
(On the development of a computer aided preoperative planning system for pelvis surgery)

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摘要(中)

骨盆手術中，通常使用CT影像資訊來幫助診斷及進行術前規劃，但由於骨盆的幾何構造複雜，一般的影像檢視，無法提供醫師術前足夠的輔助資訊，更遑論進行其他操作。在術中，為了固定破裂骨組織，必須將骨板彎折至合適的外形後再進行固定，但其作業上是相當耗時費力的。為了讓醫師有良好的術前規劃模擬及輔助手術骨板彎折，本研究發展電腦輔助骨盆手術規劃系統，而此系統架構可分為：(1)電腦斷層影像三維顯示，(2)破裂骨骼分離與三維網格模型重建，(3)破裂骨組織虛擬復位，(4)植入物置入模擬，(5)骨板術前輔助彎折，提供破裂骨組織進行復位。並於復位後之骨組織進行植入物擺放模擬，再將模擬結果輸出，利用RP技術製造輔助彎折模板，提供醫師輔助彎折。本研究藉由骨盆人工骨進行驗證其模擬結果之貼覆性，並實際以數個骨盆資料進行重建與復位，說明本系統之可行性，最後透過本系統流程進行臨床實例，驗證本研究提出之方法的可行性。

摘要(英)

關鍵字(中)

★ 骨盆骨折
★ 術前規劃
★ 復位模擬
★ 植入物置入模擬
★ 骨板彎折

關鍵字(英)

★ registration
★ bone reduction
★ pelvic surgery planning
★ pelvis fracture
★ bone plate templates

論文目次

摘要 ...................................................................................................II
Abstract ..................................................................................................III
誌謝 ................................................................................................. IV
目錄 ...................................................................................................V
圖目錄................................................................................................VII
表目錄...................................................................................................X
第一章緒論...............................................................................................1
1.1 前言...............................................................................................1
1.2 文獻回顧.......................................................................................4
1.3 研究背景說明..............................................................................6
1.4 研究目的與方法..........................................................................9
1.4.1 研究目的.............................................................................9
1.4.2 研究方法.............................................................................9
1.5 論文架構.....................................................................................12
第二章骨盆骨折手術輔助系統架構....................................................13
2.1前言..............................................................................................13
2.2骨盆及骨盆骨折介紹..................................................................13
2.3現行骨盆骨折手術醫療方式.....................................................18
2.4骨盆骨折手術輔助系統架構.....................................................20
2.4.1三維影像模型顯示............................................................22
2.4.2骨骼組織自動分離............................................................24
2.4.3破裂骨組織虛擬復位........................................................25
2.4.4植入物置入模擬................................................................25
2.4.5骨板術前輔助彎折............................................................27
第三章骨組織復位方法及植入物設計................................................30
3.1前言..............................................................................................30
3.2骨組織復位..................................................................................31
3.2.1座標轉置矩陣關係............................................................31
3.2.2 於VDCS進行平移..........................................................33
3.2.3 於垂直VDCS平面之軸進行旋轉..................................33
3.2.4 於WCS進行旋轉............................................................35
3.3骨板置入模擬方法......................................................................39
3.3.1骨板模型資料庫................................................................39
3.3.2骨板貼覆與骨板網格變形................................................41
3.4骨釘鎖入模擬及剖面瀏覽.........................................................49
3.4.1骨釘模型資料庫................................................................49
3.4.2骨釘角度調整....................................................................53
3.4.3骨釘鎖入剖面瀏覽............................................................53
第四章範例驗證及臨床實例................................................................56
4.1前言..............................................................................................56
4.2骨板貼覆驗證與輔助彎折模板.................................................56
4.3實際骨折案例模擬......................................................................59
4.4臨床實例......................................................................................73
第五章結論與未來展望........................................................................84
5.1結論..............................................................................................84
5.2未來展望......................................................................................85
參考文獻..................................................................................................87

參考文獻

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指導教授

賴景義(Jiing-Yih Lai)

審核日期

2011-7-21

推文