Year 2019 Vol. 27 No 4




Ivano-Frankivsk National Medical University 1, Ivano-Frankivsk,
Specialized (special) sanatorium "Girske povitria" 2, Yaremche,

Objective. To improve the pre-surgery planning of transosseous osteosynthesis in the shin bone fractures by developing and applying the 3-D atlas of transosseous elements positions.
Methods. On the basis of transverse computer tomographic scans of the intact lower limb of an adult using the 3-D Doctor software package, three-dimensional simulation models of the shin bones and surrounding soft tissue structures were created in the automatic mode. These models were exported as separate files into the Autodesk Inventor 11 software package. In Part Modeling mode, the division of the model of the soft tissue structures of the shin into 96 parts was carried out - the segments corresponding to the positions for passing the transosseous elements according to the method of the unified marking of transosseous osteosynthesis and their preservation in separate files. In Assembly mode, the assemblage of the shin segments has been performed.
Results. The algorithm for the creation of 3-D atlas of transosseous elements positions was proposed, according to which the three-dimensional simulation models of the shin - external fixation device system were created in the Autodesk Inventor 11 program and the analysis of their possibilities regarding pre-surgery planning of transosseous osteosynthesis was conducted.
As a result of the research, it was found out that the use of the 3-D atlas of positions provides an opportunity for selecting the optimal design and the most efficient layout of the external fixation device in each particular clinical situation; determination of the number and optimal layout levels of the supports; the choice of the type and the most appropriate places for passing of the transosseous elements.
Conclusions. The application of 3-D Atlas of transosseous elements positions permits to approach the solution of the problem of pre-surgery planning from the standpoint of an integrated approach to choosing the type of external fixation device that is adequate to the existing clinical situation, its layout, determining the number of transosseous elements, directions and planes for passing them, which will allow reducing significantly the number of technical errors, reducing the risk of complications and promoting the achievement of positive anatomical and functional results in the vast majority of clinical cases.

Keywords: three-dimensional model, external fixation device, transosseous osteosynthesis, transosseous elements, pre-surgery planning
p. 428-434 of the original issue
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Address for correspondence:
76000, Ukraine,
Ivano-Frankivsk, Galitskaya Str., 2,
Ivano-Frankivsk National Medical University,
Department of Traumatology and Orthopedics.
Tel. mobile+38050-960-59-23,
Vitalii I.Hutsuliak
Information about the authors:
Hutsuliak Vitalii I., PhD, Associate Professor of the Department of Traumatology and Orthopedics, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.
Borodajkevych Roman D., PhD, Chief Physician of the Specialized (Special) Sanatorium Girske Povitria, Yaremche, Ukraine.
Hutsuliak AndriiI., MD, Associate Professorofthe Surgery Department 1, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.
Kovalyshyn Taras M., PhD, Associate Professor of the Department of Traumatology and Orthopedics, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.
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