3D modeling in the planning of treatment of femoral tumors
Keywords:femoral tumors, 3D modeling, planning and treatment of femoral tumors
Background. The outcome of surgical treatment of fe-moral tumors (FT) depends on the knowledge of the real picture of the extent of bone and soft tissue damage. The objective picture of the lesion can be significantly supplemented by virtual modeling in the framework of MRI, CT, and 3D modeling of the process, which is practically not studied in Ukraine. Real solid modeling of a skeletal segment with a tumor can produce the most optimal volume of resection and structure formation for stable fixation of bone fragments. The purpose of the work is to improve the technique of 3D modeling of hip tumors for preoperative planning of surgical intervention and the development of the most optimal design of the device. Materials and methods. The available literature data were analyzed; the radiographs, case histories of 15 patients with FT were studied. Good results of treatment of the last are possible at thorough preoperative planning. Results. We use technologies of 3D modeling and 3D printing of solid models of FT. This allows planning the line of the proposed bone resection, to properly form a graft from bioactive ceramics, tutoplast or own bones. 3D modeling helps to create the most optimal design of the device, which provides stable fixation of these grafts to the femoral fragments. The length of resection of the tumor segment with the tumor was calculated using multidetector compu-ted tomography (MDC) perfusion. This makes it possible to conduct preoperative training to establish the structures of the formed fixators on the segment of bone fragments — graft (BFG), to determine its bearing capacity. Based on planning and preoperative training, 5 ope-
rations were performed on the hip. To stabilize the BFG segment, optimized constructions based on a DHS-type clamp, LCP-plates, or a clamp for low-contact multiplane osteosynthesis were used. Conclusions. Application of the technology of 3D modeling and 3D printing of solid models of specific SC and tumors allow planning the line of the proposed bone resection. Based on this, you can form the size of the graft, create a fixator structure that provides stability in the BFG. The preoperative training facilitates surgery. All this helps to choose the most optimal treatment tactics.
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