A Parametrization Approach for 3D Modeling of an Innovative Abduction Brace for Treatment of Developmental Hip Dysplasia

摘要

Developmental hip dysplasia (DHD) is frequently encountered in the pediatric orthopedic practice. DHD is characterized by dislocation of the femoral head in the acetabulum. In Brazil are diagnosed three times more cases than the world average (5-8 cases for 1,000 births). The lack of treatment leads to long-term morbidity, abnormal gait, chronic pain and arthritis. Early detection and treatment with a Pavlik harness results in improved outcomes. After 6 months of age, closed or open reduction with spica casting is required for 4 months to treat a persistent hip dislocation. Plaster is used for orthopedic immobilization due the low cost, moldability and good mechanical resistance. However, there are several risks and complications due to the use of spica cast in DHD treatment: Skin problems due to lack of adequate hygiene (itching, ulceration, dermatitis and infection), formation of pressure areas, plaster fracture (11% of cases) and fever. Digitization techniques have been explored for production of customized hip abduction brace by additive manufacturing. However, it is not possible to keep a child standing still to perform 3D scanning of the hip and legs region. The goal of this research was to develop an alternative approach for acquisition of the external geometry of the infant to create 3D model of an abduction brace. The parameterization technique created includes: The creation of a virtual 3D model of a child's body using the MakeHuman software; Articulation of the hip region of the model to the position required in the treatment of DHD with the Blender software; Definition of the parameters required for the modeling of a hip abduction brace. A DHD pediatric orthopaedist approved the methodology created. Innovations in the area of assistive technology can bring many benefits to the user in the process of rehabilitation.