Effect of computer virtual technique combined with pelvic reduction frame in the treatment of type C pelvic fracture / 中国骨伤

OBJECTIVE@#To investigate the short-term clinical effect of the computer virtual technique combined with pelvic reduction frame in the treatment of complex pelvic fractures.@*METHODS@#Thirty patients with Tile C pelvic fractures treated by percutaneous minimally invasive pelvic reduction frame from April 2018 to April 2020 were retrospectively analyzed, including 21 males and 9 females, aged from 19 to 57 (39.40±9.85) years old. The patient's pelvic CT DICOM data were imported into Mimics software to reconstruct the virtual fracture model. Virtual reduction and nail placement were carried out on the fracture model, and then simulated fluoroscopy was carried out to record the ideal fluoroscopy orientation and angle to guide the correct fluoroscopy during operation. The operation time, fluoroscopy times and intraoperative blood loss were recorded. The quality of fracture reduction was evaluated by Matta image score standard, and the postoperative function was evaluated by Majeed function score standard.@*RESULTS@#All 30 patients achieved closed reduction and percutaneous screw fixation. According to Matta score, the excellent and good rate of fracture reduction was 93.3%(28/30). A total of 67 channel screws were inserted, and the excellent and good rate was 98.5%(66/67). The operation time was (173.54±79.31) min, fluoroscopy time was (90.81±41.11) times, intraoperative blood loss was (81.21±43.97) ml. All incisions healed at one stage without broken nails or re-displacement of fractures. All patients were followed up for 12 months. At the final follow-up, Majeed function score was 73 to 94(85.66±5.33) scores.@*CONCLUSION@#Computer virtual technology combined with pelvic reduction frame could rapidly, accurately and safely reduce and fix unstable pelvic fractures. Computer virtualization could help surgeons to recognition and understanding pelvic fractures, pelvic reduction frame could improve the surgeon's ability to manage complex and unstable pelvic injuries.

The optimal pathway for S1 sacroiliac screwing: 3D imaging study and clinical application / 中华创伤骨科杂志

Objective To determine the optimal pathway for S1 sacroiliac screwing based on the largest safe zone in Chinese population using 3D imaging models and observe its clinical application in patients with sacroiliac joint fracture or dislocation.Methods Pelvic CT scans of 54 Chinese adults were obtained to create reconstruction 3D models of the right hemi-pelvis.After the models were transparentized and rotated to the axial view of the S1 pedicle,the angle was slightly adjusted to maximize the translucent safe zone.Next,simulative insertion into the center of this zone was conducted with one virtual screw,as large as possible and tangent to the boundary.Measured were the diameter and length of the screw,the vertical distances from the entry point to the horizontal tangent line of the greater sciatic notch and to the vertical tangent line of the posterior superior iliac spine,and from the exit point to the S1 superior endplate and to the anterior cortex.The differences between males and females were analyzed.The above parameters of the optimal pathway for S1 sacroiliac screwing were used in insertion of 16 screws in the 12 patients with sacroiliac joint fracture or dislocation from January 2014 to January 2016 at Department of Orthopaedics and Traumatology,Nanfang Hospital.They were 8 males and 4 females,from 16 to 47 years of age (average,34 years).According to the Tile classification,6 cases belonged to Type Ⅱ and 6 ones to Type Ⅲ.The efficacy of S1 sacroiliac screwing was observed.Results In all the pelvic 3D imaging models,an oval translucent area for safe screw insertion could be easily identified from the S1 pedicle axial view.The maximum diameter and length of the optimal intraosseous pathway were 13.66 ±2.04 mm and 77.66 ±4.25 rmm;the vertical distances from the entry point to the horizontal tangent line of the greater sciatic notch and to the vertical tangent line of the posterior superior iliac spine were 32.77 ± 4.55 mm and 49.57 ± 5.24 mm;the vertical distances from the exit point to the S1 superior endplate and to the anterior cortex were 9.30 ± 1.54 mm and 15.85 ± 2.12 mm.The differences were of statistical significance between males and females regarding the maximum diameter,the distance from the entry point to the vertical axis,and the distance from the exit point to the anterior cortex (P ＜ 0.05).All the 16 screws were safely implanted in the 12 patients.Conclusion The optimal screw pathway can be easily identified and its parameters can be measured in pelvic 3D imagingmodels using computer virtual technology.The clinical application has proved that the parameters can serve as a theoretical basis for safe placement of S1 sacroiliac screws.

The construction of visualization system for the meridians and acupoints of human body using three-dimensional virtual technology / 国际中医中药杂志

Objective The solution for the cross-platform of visualizing human meridian acupoints by three-dimensional (3D) virtual technology was explored based on existing researches to improve interactive method.Methods 3D virtual technology was utilized to construct a 3D visualization model of human meridians and acupoints.The cross-platform 3D visualization system was realized by integrating the existing relevant standards and clinical knowledge.Results The system can visually and dynamically show the meridians and acupoints of human body.Moreover, it can reveal the details including part meridian circulation, the spatial structure of acupoints, etc which fail to be reflected by the real acupuncture model and two-dimensional (2D) planar chart.Meanwhile, the system can be employed to realize the visualization interaction between meridians model and human beings, and the multi-screen cross-platform user scenarios in the whole network.Conclusion It is expected to be widely applied in fields, such as teaching of traditional Chinese medicine (TCM), scientific research, science popularization, etc.

Efetividade da reabilitação virtual no equilíbrio corporal e habilidades motoras de indivíduos com déficit neuromotor: uma revisão sistemática / Effectiveness of the virtual rehabilitation on body balance and motor abilities of individuals with neuromotor impairment: a systematic review

As capacidades físicas são reduzidas em indivíduos com prejuízo neuromotor. O equilíbrio e a motricidade são afetados por enfermidades no sistema nervoso. A realidade virtual (RV) tem sido utilizada para a recuperação do equilíbrio e função motora desses indivíduos, mas sua efetividade é pouco conhecida. O objetivo do presente estudo foi identificar e analisar estudos que investigaram a efetividade da tecnologia virtual na reabilitação do equilíbrio corporal e habilidades motoras de indivíduos com déficit neuromotor. Foram incluídos ensaios clínicos e/ou experimentos controlados e randomizados publicados em inglês e português entre 2001 e 2011, que utilizaram como terapia exercícios com RV para indivíduos de ambos os gêneros, com enfermidades neurológicas e idade igual ou superior a 45 anos. As bases de dados consultadas foram: Medline, BVS, PEDro e SciELO. Também foram considerados estudos encontrados nas referências de outras revisões. Para avaliação da qualidade científica dos artigos utilizou-se a escala PEDro. Estudos com o mínimo de 6 pontos nessa escala foram incluídos e analisados, totalizando sete estudos. As médias do tamanho do efeito da reabilitação virtual para o equilíbrio corporal (0,50 ± 0,35) e para as habilidades motoras (0,52 ± 0,34) foram superiores às de outras intervenções (0,17 ± 0,16 e 0,25 ± 0,22 respectivamente). A RV mostrou-se efetiva na reabilitação do equilíbrio corporal e habilidades motoras de indivíduos com déficit neuromotor, mas a quantidade de evidências ainda é limitada. Apesar do efeito positivo apresentado, o método deve ser utilizado com atenção e também pesquisado em sujeitos com outros quadros clínicos.

The physical capabilities are reduced in individuals with neuromotor damage. The balance and motor skills are affected by diseases in the nervous system. Virtual reality (VR) has been used to balance recovery and motor function these individuals, but its effectiveness is not fully known. The aim of this study was to identify and analyze studies that investigated the effectiveness of virtual technology in the rehabilitation of the body balance and motor skills of individuals with neuromotor deficits. We included clinical trials and / or randomized controlled trials published in English and Portuguese between 2001 and 2011, wich used with VR exercises as therapy for individuals of both genders, aged 45 years or more with neurological disorders. The following databases were consulted: Medline, BVS, SciELO and PEDro. Studies found in the references were also considered for further reviews. The PEDro scale was used to evaluate the scientific quality of articles. Studies with a minimum of 6 points on this scale were included and analyzed, totalling of seven studies. The mean effect size for the virtual rehabilitation body balance (0.50 ± 0.35) and motor skills (0.52 ± 0.34) were better to other interventions (0.17 ± 0.16 and 0.25 ± 0.22 respectively). VR proved to be effective in the rehabilitation of the body balance and motor skills of individuals with neuromotor deficits although the amount of evidence is still limited. Despite the positive effect shown the method should still be used with care and also studied in subjects with other conditions.

Research of Virtual Laboratory in Medicine Based on Virtual Technology / 中华医学教育探索杂志

This paper discusses how to build a virtual laboratory in medicine based on virtual technology,and studies the virtual reality,virtual instrument,virtual laboratory and its features and significance in experiment teaching.