基于三维外形数据的先天性并指畸形分析和分指术设计研究

Congenital syndactyly is one of the most common hand deformity and affects the physical and mental development of children seriously. Due to complexity and diversity of manifestation, the local flap design of web space and digit body often depends on clinical experience, which poses a great challenge to the surgeons. By leveraging three-dimensional computer modeling and measurement、analysis, this project will focus on the two scientific problems: the difference analysis of shape parameters between normal and deformity hands and the principles inside the changes of function and appearance, then investigate the three-dimensional hand model based morphology analysis and surgical design for congenital syndactyly. We have carried on reconstruction of hand three-dimensional model and studies of its accuracy and reliability, and quantitative evaluation of syndactyly and computer-aid flap design. Based on our existing work, the project aims to establish a three-dimensional modeling method for data-driven multi-posture normal and deformity hands, and propose a standardized method for measuring indicators and reveal the law of skin distribution in different regions, and present the preoperative assessment of skin tension, quantified methods for local flap design of web space and digit body, and evaluation criteria for postoperative function and appearance, etc. The project is expected to provide a quantitative system for the scientific design, optimization, and evaluation of surgery of hand deformity, with significant scientific and clinical values.

先天性并指畸形是最常见的手部畸形之一，严重影响儿童身心发育。以往分指术中指蹼区和指体区局部皮瓣的设计主要依赖于临床经验，但并指畸形表现的复杂性和多样性给外科医生提出了极大挑战。本项目拟以计算机三维建模和测量分析为手段，围绕正常手与并指手皮肤分布的差异性模型和分指术切口参数对术后外观、功能的作用机理这两个科学问题，开展基于三维外形数据的先天性并指畸形术前分析和分指术设计研究。前期我们已构建手三维模型，完成了精确性和可靠性分析、并进行了并指畸形的测量与量化评估以及计算机辅助皮瓣手术设计的研究。在此基础上，本项目将建立数据驱动的多姿势正常手和并指手的三维模型构建方法，提出三维重建手的测量指标，揭示不同区域皮肤分布的规律，提出并指手的术前皮肤紧张度评估、量化的指蹼区和指体区局部皮瓣的设计方法和术后功能、外观的评价标准，构建分指术科学的设计、优化和评价的量化体系，具有重要的科学意义和临床价值。

先天性并指畸形是最常见的手部畸形之一，严重影响儿童的身心发育。以往分指术中指蹼区和指体区局部皮瓣设计主要依赖于临床经验，但并指畸形表现的复杂性和多样性导致术后并发症发生率高，患者满意度低。本项目拟以计算机三维建模和测量分析为手段，围绕正常手与并指手皮肤分布的差异模型和分指术切口参数对术后外观、功能的作用机理这两个科学问题，先后开展结构光扫描三维系统的可靠性和准确性评估，指蹼区和指体区的三维测量，对休息位、功能位、外展位等手模型的三维重建，同时研发并指畸形手部测量和辅助手术装置，对手指稳妥固定的同时精准标记，可实现将计算机设计方案精准映射到实体手上；最后，临床经验结合计算机辅助测量数据，开展了新型指蹼瓣的设计和对原先指蹼瓣的优化，提高了手术效果。本项目研究过程中，共发表论文5篇，其中2篇为SCI，授权国家专利1项，获得欧洲手外科学会联合会大会和世界骨科大会口头发言共5次，国内大会交流4次。本项目的成果为并指畸形的手术研究提供了重要的科学依据。