Rekonstrukce acetabula s využitím reálného modelu pánve

ortopedic, CT, hip joint, surgery, real model, surgery planning

Implantation of total hip prostheses in the terrain of postraumatically mutilated acetabulum with large bone defects represents still a serious problem in orthopaedics. Number of complex pelvic injuries and also of isolated acetabular fractures increases constantly and the results of implants of total hip prostheses in large acetabular defects are poor. These surgeries are very difficult from the technical point of view and preoperative planning is often based on imprecise and vague criteria of conventional radiographs. Location and degree of bone loss are the principal determinants of surgical success and consequent functional outcome in the r reconstruction of the hip joints. While the inclusion of additional radiographic views and CT may enhance the description of the defect, it does not give a global or surgically realistic representation of the defect. The usage of real three-dimensional physical model of pelvis, based on 3-D CTMD examination, helps to better description of acetabular defects and facilitates preoperative planning. With help of the model, the surgeon analyses the state of acetabulum, determines the plan of surgical output, makes decision about necessity of bone grafts application, event. of augmentation of acetabulum by the plate or ring, and preselects the optimal implant. The advantage of the real model is the possibility of implantation of trial prosthesis on the model and testing of its stability. Using of the real model of pelvis proper operation time and number of complications.