تعیین موقعیت سوراخ انتهایی میله‌ی درون‌استخوانی با استفاده از مدل‌سازی مکانیکی و داده‌های تصویری از انحنای میله

نوع مقاله: مقاله کامل پژوهشی

نویسندگان

1 دانشجوی دکتری، دانشکده‌ی مهندسی مکانیک، دانشگاه صنعتی شریف، تهران

2 استاد، دانشکده‌ی مهندسی مکانیک، دانشگاه صنعتی شریف، تهران

3 دانشیار، دانشکده‌ی مهندسی مکانیک، دانشگاه صنعتی شریف، تهران

4 دانشیار، گروه ارتوپدی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی ایران، تهران

10.22041/ijbme.2018.87737.1360

چکیده

میله­گذاری درون‌استخوانی روشی رایج در درمان شکستگی­های تنه­ی استخوان فمور می‌باشد. به علت تغییر شکل میله در فرایند جای‌گذاری درون کانال استخوان، بستن پیچ انتهایی میله برای جراحان چالش برانگیز و زمان­بر است. تغییر شکل میله باعث می­شود که استفاده از فیکسچرهای متصل به میله برای یافتن محل صحیح سوراخ انتهایی، کارآمد نباشد. در مطالعات پیشین برای تعیین موقعیت و راستای سوراخ انتهایی، اغلب تنها هندسه­ی قسمت انتهایی میله مورد توجه قرار گرفته است. هدف پژوهش حاضر بررسی فرضیهی امکان استفاده‌ی ترکیبی از روش­های تحلیل مکانیکی میله و داده­های تصویری برای تعیین موقعیت سوراخ انتهایی میله می­باشد. در روش پیشنهادی، رفتار میله با توجه به مشخصات هندسی آن (نسبت طول به قطر بین 25 تا 50) با استفاده از مدل تیر اویلر-برنولی شبیه­سازی شده و الگوی تغییر شکل آن به دست می‌آید. سپس با انطباق الگوی تغییر شکل بر تصویر میله در صفحه­ی کناری و استفاده از الگوریتم تکراری نزدیک­ترین نقاط، تغییر شکل میله و موقعیت سوراخ انتهایی محاسبه می‌گردد. به منظور ارزیابی فرضیهی پژوهش و سنجش دقت محاسبه‌ی موقعیت سوراخ انتهایی بر اساس روش پیشنهادی، آزمایش روی 5 نمونه از استخوان فمور جسد انسان صورت پذیرفت و موقعیت پیش‌بینی شده و واقعی سوراخ انتهایی مورد بررسی قرار گرفت. نتایج نشان داد که با استفاده از تحلیل مکانیکی و داده‌های تصویری از انحنای میله، موقعیت سوراخ‌های انتهایی با خطای موثر میانگین 84/0 میلی‌متر و خطای حداکثر  3/1 میلی‌متر محاسبه می‌گردد. انتظار می‌رود که با ترکیب روش پیشنهادی با روش‌های تصویری مبتنی بر شکل سوراخ، بتوان در آینده به خطای کم‌تر از میلی‌متر در تعیین موقعیت سوراخ دست یافت.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Estimating the Position of Distal Hole of Intramedullary Nail using Mechanical Modeling and Image Curvature Data

نویسندگان [English]

  • Javad Mortazavi 1
  • Farzam Farahmand 2
  • Saeed Behzadipour 3
  • Ali Yeganeh 4
1 Ph.D Student, Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran
2 Professor, Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran
3 Associate Professor, Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran
4 Associate Professor, Department of Orthopedic Surgery, Iran University of Medical Sciences, Tehran, Iran
چکیده [English]

Intramedullary nailing is a common technique for treatment of femoral shaft fractures. Nail deformation after insertion into the bone, makes the distal hole locking a challenging task for the surgeon. The proximally mounted targeting systems for locating the position of the distal hole become ineffective due to the nail deformation. The previous image-based techniques have often considered the shape of the distal end of the nail only to find the position and direction of the distal hole. The purpose of this study was to evaluate the hypothesis of possibility of locating the position of the distal hole using mechanical modeling and radiography data simultaneously. In the proposed method, according to the nail geometry (length to diameter ratio between 25 and 50), an Euler-Bernoulli beam model is used to simulate the mechanical behavior of the nail and calculate its deformation pattern. Then, by registering the deformation pattern with the sagittal radiography image of the nail, using iterative closest point algorithm, the nail deformation and the position of the distal hole are predicted. In order to evaluate the research hypothesis, a number of experiments were performed on five cadaveric femurs and the predicted and actual positions of the distal hole were compared. Results indicated that by using mechanical modeling and the imaging data of the nail curvature, the position of the distal hole could be predicted with a mean error of 0.84 mm and a maximum error of 1.3 mm. It is expected that by combining the proposed method with the image-based techniques, which make use of the shape data of the hole, a sub-millimeter error in locating the distal hole could be achieved in future.

کلیدواژه‌ها [English]

  • Orthopedic Surgery
  • Femur Fracture
  • Computer-Aided Surgery
  • Iterative Closest Point

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