Application of three-dimensional reconstruction using Mimics software to repair of Pilon fracture. doi: /j.issn

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19 44 20151022 Chinese Journal of Tissue Engineering Research October 22, 2015 Vol.19, No.44 MimicsPilon ( 528415) 1 Pilon 2 CT Mimics V 10.0 Pilon 3 Pilon Mimics Mimics Mimics Pilon (20113A014) Mimics CT CTMRI Mimics Pilon 2008 9 2013 9 Pilon 61 X CT Mimics 10.0 (P < 0.05) 6 6 (P < 0.05) Pilon Mimics 1973 1995 528415 :R318 :B :2095-4344 (2015)44-07167-05 2015-08-12 http://www.crter.org. Mimics Pilon [J].201519(44):7167-7171. doi:10.3969/j.issn.2095-4344.2015.44.021 Application of three-dimensional reconstruction using Mimics software to repair of Pilon fracture Huang Jian, Wang Xiao-ping, Deng Zhi-cheng, Wu Wei-wei, Chen Lu-yao, Hu Shi-qiang, Wei Zhan-tu, Guo Sheng (Department of Orthopedics, Zhongshan City Xiaolan People s Hospital, Zhongshan 528415, Guangdong Province, China) Abstract BACKGROUND: Mimics software is a three-dimensional (3D) image processing and editing tool based on CT scan data. Mimics software can rebuild the data and images gotten in CT, MRI and ultrasound scans into 3D images and display on the computer screen so as to help clinicians understand the type of fracture and the relationship of the 3D structure of the surrounding tissue and to provide a great help in the development of orthopedics operation. OBJECTIVE: To explore the application effect of Mimics software 3D reconstruction on perioperative period of Pilon fracture. METHODS: This study selected 61 cases of Pilon fracture, who received the surgery in the Zhongshan City Xiaolan People s Hospital from September 2008 to September 2013, as research objects. They were randomly divided into 3D group and control group in accordance with the time of admission. All patients underwent anterioposterior and lateral X-ray film examination and multi-slice spiral CT scan. Patients in the control group received internal fixation according to above examination results. Patients of the 3D group, on the base of those of Huang Jian, Attending physician, Department of Orthopedics, Zhongshan City Xiaolan People s Hospital, Zhongshan 528415, Guangdong Province, China Corresponding author: Deng Zhi-cheng, Department of Orthopedics, Zhongshan City Xiaolan People s Hospital, Zhongshan 528415, Guangdong Province, China Accepted: 2015-08-12 ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 7167

. Mimics Pilon the control group, were subjected to internal fixation after three-dimensional entity reconstruction by using Mimics V 10.0 software. Operation time and functional curative effect in the postoperative follow-up were compared between the two groups. RESULTS AND CONCLUSION: The operation time was significantly less in the 3D group than in the control group (P < 0.05). The number of patients with excellent 6-month functional curative effect was more, and the number of patients with poor effect was less in the 3D group than in the control group. The 6-month functional curative effect was better in the 3D group than in the control group (P < 0.05). These results showed that the application of Mimics software 3D reconstruction to the perioperative period of Pilon fractures can give comprehensive assessment of the situation of fracture, optimize and improve the preoperative plan and reduce the risk of surgery, and promote the successful completion of internal fixation. Subject headings: Tibial Fractures; Imaging, Three-Dimensional; Internal Fixators; Follow-Up Studies; Tissue Engineering Funding: the Zhongshan Science and Technology Project, No. 20113A014 Huang J, Wang XP, Deng ZC, Wu WW, Chen LY, Hu SQ, Wei ZT, Guo S. Application of three-dimensional reconstruction using Mimics software to repair of Pilon fracture. Zhongguo Zuzhi Gongcheng Yanjiu. 2015;19(44):7167-7171. 0 Introduction Pilon 1%1/4 [1-2] Pilon XCT [3] CTMimics 10.0 Pilon Mimics Pilon MimicsPilon 1Subjects and methods 1.1 1.2 2008920139 1.3 1.4 2008920139 Pilon61 (n=31)(n=30) 3118131869 48.6Ruedi-Allgower [4] 9 121014 1217 7168 3019111869 48.6Ruedi-Allgower7 1581313 19 4 h6 d (P > 0.05) XCTPilon Pilon Pilon 1.5 X CT [5]Mimics10.0CT CTDICOM MIMICS 10.0(Thresholding) (3D Region Growing) optima3d.stl1 P.O. Box 10002, Shenyang 110180

. Mimics Pilon 3 MIMICS 10.0 MIMICS 10.0 MIMICS 10.0 Solidworks 2007.sd MIMICS 10.0 1.6 12MARSH [6] MARSH>92 8792 3/4 65861/2 < 651/2 1.7 SPSS 17.0 12 2 x±s t P < 0.05 2Results 2.1 Pilon 6131 30 2 2.2 (P > 0.05)1 2.3 (P < 0.05)2 2.4 12 ( 2 =9.82 P < 0.05)3 2.5 57Pilon Ruedi-Allgower MIMICS 10.0 3 2.6 31 22 1 3 2 3Discussion Pilon [7] Pilon Mimics 10.0CT CTMRI Pilon Pilon [8] PilonX CT Pilon [9] CT CT [10] Mimics CT CT [11] ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 7169

. Mimics Pilon A B C D 1 Ruedi-Allgower Pilon MIMICS 10.0 Figure 1 Mimics 10.0 software reconstruction in patients with Ruedi-Allgower II Pilon fracture A MIMICS 10.0 B Mimics C Mimics D MIMICS 10.0 3 Pilon MIMICS Figure 3 Images of a patient with Pilon fracture after Mimics reconstruction MIMICS CT X 1 Table 1 Comparison of baseline data in the two groups (n=31) (n=30) P /(n) 18/13 19/11 > 0.05 () 48.6 48.6 > 0.05 Ruedi-Allgower (// n) 9/12/10 7/15/8 > 0.05 2 (x±s) Table 2 Comparison of operation time of patients in both groups n (min) 30 185.6±64.5 31 145.6±42.5 t 2.990 P 0.004 3 12 (n/%) Table 3 Comparison of functional effects at 12 months after treatment in patients of both groups n 30 8/27 12/40 6/20 4/13 31 21/67 6/20 4/13 0/0 Mimics [12] Mimics 7170 2 Figure 2 Packet flow chart of patients in both groups CT (P < 0.05) [13] P.O. Box 10002, Shenyang 110180

. Mimics Pilon Pilon Mimics [14-22] Mimics Pilon Pilon 1% 1/4 Pilon () 4 References [1]..86Pilon[J]., 2014,22(6):463. [2] Watson JT,Wiss DA. Fractures of the proximal tibial and fibula.phila delphia:lippincott Williams &Wilkins, 2001: 1801-1841. [3] Dai LY,Wang XY,Jiang LS. Plain radiography versus computed tomography scans in the diagnosis and management of thoracolumbar burst fractures. Spine. 2008; 33(16):E548-E552. [4] Lovisctti G,Agus MA,Pace F. Management of distal tibial intraarticular fractures with circular external flxation. Strat Traum Limb Recon. 2009;4(1):1-6. [5],.Pilon[J].,2011, 14(2):141-142. [6] Lin WC,Liang CC,Chen CT. Dynamic elastic interpolation for 3-d medical image reconstruction from cross-sections. IEEE Trans Med Imaging. 1988;(3):225-232. [7] Letts M,Davidson D,McCaffrey M. The adolescent pilon fracture:management and outcome. J Pediatr Orthop. 2001; (1):20-26. [8] Valentini MC,Busch R,Ferraris MM. The role of imaging in the choice of correct treatment of unstable thoraco-lumbar fractures. Eur J Radiol. 2006;(3):331-335. [9] Bernstein MP,Mirvis SE,Shanmuganathan K. Chance-type fractures of the thoracolumbar spine:imaging analysis in 53 patients. Am J Roentgenol. 2006; 187(4):859-868. [10].CT[J].,2014,22(20):45-46. [11],,,.CT [J].,2012,16(9):1688-1691. [12],,,. [J].,2013,15(7):619-621. [13].Mimics [D].,2014. [14] El-Mowafi H, El-Hawary A, Kandil Y. The management of tibial pilon fractures with the Ilizarov fixator: The role of ankle arthroscopy. Foot (Edinb). 2015. pii: S0958-2592(15)00070. [15] Colegate-Stone T, Marenah K, Compson J, et al. Functional Outcomes Following Pilon Fractures of the Middle Phalanx Managed with the Ligamentotaxor External Fixator. Hand Surg. 2015;20(2):285-289. [16] Song Z, Xue HZ, Zhang K, et al. Pathogenesis and Treatment Strategies for Pilon Fractures With Ankle Dislocation. J Foot Ankle Surg. 2015;54(5):815-820. [17] Krettek C, Bachmann S. Pilon fractures. Part 2: Repositioning and stabilization technique and complication management. Chirurg. 2015;86(2):187-201; quiz 202-203. [18] Li Q, Zhao WB, Tu CQ, et al. [Locking compression plate (LCP) combined with minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of Pilon fracture]. Zhongguo Gu Shang. 2014;27(12):1029-1032. [19] Lomax A, Singh A, Jane M,et al. Complications and early results after operative fixation of 68 pilon fractures of the distal tibia. Scott Med J. 2015;60(2):79-84. [20] Hsu AR, Szatkowski JP. Early Tibiotalocalcaneal Arthrodesis Intramedullary Nail for Treatment of a Complex Tibial PilonFracture (AO/OTA 43-C). Foot Ankle Spec. 2015;8(3): 220-225. [21] Liu DC, Yang XN, Huang CZ, et al. Over-articular external fixator combined with limited internal fixation for the treatment of high-energypilon fractures. Zhongguo Gu Shang. 2014; 27(4): 331-334. [22] Assal M, Ray A, Fasel JH, et al. A modified posteromedial approach combined with extensile anterior for the treatment of complex tibial pilon fractures (AO/OTA 43-C). J Orthop Trauma. 2014;28(6):e138-145. ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 7171