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研究生:詹濬瑜
研究生(外文):Chun-YuChan
論文名稱:三維量測應用於快速成型小腿義肢承筒模型之驗證
論文名稱(外文):The Verification of Rapid Prototyping Transtibial Socket Mold Using 3D Measuring Methods
指導教授:許來興
指導教授(外文):Lai-Hsing Hsu
學位類別:碩士
校院名稱:國立成功大學
系所名稱:機械工程學系碩博士班
學門:工程學門
學類:機械工程學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:中文
論文頁數:79
中文關鍵詞:小腿義肢全接觸承重式與髕骨腱承重式承筒真空成形取模工具三維掃描器快速成型機
外文關鍵詞:Prosthetic SocketTotal Surface BearingPatella Tendon BearingVacuum Forming Tool3D ScannerRP Machine.
相關次數:
  • 被引用被引用:3
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小腿義肢承筒製作為高度客製化之產品,承筒優劣取決於義肢師個人的技術與經驗,使得承筒製作的品質無法穩定。本研究嘗試採用以簡單的取模工具,簡易型的三維掃描系統和快速成型機(RP, Rapid Prototyping)建立一套成本低廉的CAD/RP承筒製作流程,以改善承筒製作品質的不穩定性。目標為簡化手工石膏修模的繁複過程,協助臨床經驗不多的義肢師能容易製作出品質穩定的小腿義肢承筒。
本研究導入髕骨韌帶承重式(PTB, Patella Tendon Bearing)承筒的概念應用在真空壓力取模工具。在患者脛骨及腓骨等非耐壓區黏貼軟墊增加空間,且依據殘肢狀態需求來評估軟墊的厚度、範圍區域及形狀大小,在壓力取模的環境下利用軟墊對髕骨韌帶實行加壓,在髕骨韌帶形成往內壓縮的空間,增加其承重力。
CAD/RP製程中所使用的設備為簡易型三維掃描機與快速成型機,因為設備上的誤差會影響最後製作的小腿義肢承筒,所以需要驗證其精度對於承筒的影響。其驗證方法為利用高精度的三維掃描機,分別對真空成形之殘肢陽模與快速成型承筒模型進行掃描,再與製程使用的三維掃瞄機和CAD承筒模型檔案分別比較其誤差,所測得的精度誤差範圍,簡易型三維掃描機平均為0.8mm,快速成型機平均在0.2mm,其形狀誤差在承筒製作上是可以接受。
本研究有兩位單側小腿截肢患者參與實驗,經由本研究建立之CAD/RP製程所製作的承筒。經患者試穿承筒,並進行介面壓力量測。由患者本身主觀的認為,在穿戴上並無疼痛的現象,行走正常無不適。而壓力實驗結果在受壓區及非受壓區的量測結果表現也較好,由實際案例的實驗成果,確認CAD/RP製程使用軟墊調整殘肢形狀後取模,採用簡易型三維掃描機及快速成型機,製作小腿義肢承筒,可以協助經驗不多的義肢裝具師,容易設計製作出患者可以舒適使用的承筒。

The prosthetic transtibial socket for a specific amputee should be custom-made and usually fabricated by a well-experienced prosthetist based on plaster-based manual method. The determination of socket shape at the pressure relief and pressure tolerant areas during the modification of plaster stump mold is the key step of the quality of socket fit. However, to cultivate a well-skilled prosthetist takes a long period of time and cases of bad socket fit to cause amputee discomfort occur from time to time. The main objective of this study is to develop an effective process that may improve the uncertainty quality of socket fabrication by employing easily-used tools to assist a less experienced prosthetist to fabricate transtibial sockets with comfortable fit.
In this research, the concept of total surface bearing (TSB) socket is employed when duplicating a stump mold by using a vacuum tool. During the step of forming stump mold, patella tendon bearing concept is adopted by sticking a crescent-shaped bar onto patella tendon area and pasting soft pads , on tibia and fibula bones so that the modified shape of duplicated stump mold can create a good fit of socket with acceptable pressure distribution on stump.
For the accuracies of simple type 3D scanner and RP machine adopted in the CAD/RP socket fabrication process , need to be verified. A higher accurate 3D scanner was used to measure the shapes of duplicated stump molds and RP socket molds and then compare to the CAD model created in a CAD socket design system. The accuracy of simple type 3D scanner is 0.8mm. And the accuracy of 0.2 mm for entry-level RP machine is acceptable for CAD/RP socket Manufacture fabrication method.
Two unilateral amputees participated in this research to verify the applicability of the CAD/RP Transtibial socket fabrication process by measuring the interface pressure distribution between socket and stump. According to amputees’ subjective opinions, there were no pains on stump while wearing the sockets fabricated by the CASD/RP process and , walking normally without discomfort. The experimental results showed that the interface pressures are reasonable. By employing easily-used tools, including a vacuum forming device together with shape modification method, simple type 3D scanner and rapid prototyping (RP) machine, an RP sockets mold can replace a plaster stump mold that is heavily relied on manual skills to fabricate transtibial socket. The proposed CAD/RP process can help a prosthetist with less experience to fabricate prosthetist prosthetic sockets with acceptable quality.

摘要 I
Abstract II
誌謝 IV
目錄 V
圖目錄 VII
表目錄 X
第一章 緒論 1
1.1 前言 1
1.2 研究動機與目的 1
1.3 論文架構 2
第二章 文獻回顧 3
2.1何謂殘肢 3
2.2小腿義肢的組成 5
2.3 全接觸承重式承筒與髕骨腱承重式承筒 6
2.4 現有全接觸承重式取模技術介紹 8
第三章 膝下小腿義肢承筒CAD/RP製程 12
3.1 傳統手工承筒製程 12
3.2 CAD/ RP承筒製程 17
3.2.1 真空成形殘肢取模 18
3.2.2掃描與建立殘肢取模模型 25
3.2.3編修殘肢CAD模型 28
3.2.4製作RP承筒模型 31
3.2.5製作PP承筒且修整、調整承筒配置 32
3.3 CAD/RP製程與傳統手工製程比較 34
第四章 三維掃描機與快速成型機 35
4.1 簡易型三維掃描器 35
4.1.1 David laserscanner使用介紹 35
4.1.2 驗證簡易型掃描機David laserscanner精準度 40
4.2 簡易型快速成型機 46
4.2.1快速成型機BFB3000 Plus 3D Printer使用介紹 46
4.2.2驗證BFB 3000Plus 3D Printe精準度 49
第五章 案例研究 54
5.1 髕骨韌帶軟墊形狀探討 54
5.2 CAD/RP製程實際應用 58
5.2.1患者資料 58
5.2實際應用 58
5.3介面壓力量測實驗 69
5.3.1案例一實驗結果 69
5.3.2案例二實驗結果 72
第六章 結論 75
6.1研究成果與討論 75
6.2建議 75
參考文獻 77

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