Büyük kemik kusurları için özelleştirilebilir, modüler doku iskele bloklarının tasarımı ve eklemeli imalatı

Bone has an excellent capacity to regenerate itself after damage, especially for minor defects. However, for large bone defects, external intervention is needed. One of the most suitable external treatments for large bone defects is bone scaffolds. However, the transplanted scaffold must conform to the unique morphological features of the patient's bone while providing adequate biomechanical support with the 3D porous inner structure. With additive manufacturing (AM), producing a structure that meets these requirements is possible. But the current customized scaffold design method (reverse engineering technique) is time-consuming, labor-intense and expensive due to the software and machinery used in the process (2D medical image acquisition machine, medical image processing software), and the joint work of technical and surgical staff to finalize the design of the scaffold. Depending on the complexity of the case, the design phase can take months. But in some cases, like high energy injuries, the proper treatment should be held in the fastest way possible. Otherwise, the patient may face severe and irreversible problems like unbearable pain, long hospitalized time, and even limb loss. In this thesis, a method of constructing a best fitting scaffold for the treatment of large bone defects from pre-printed modular blocks is introduced. A femur surface modeling algorithm using morphological features of the femur as input was created. With this algorithm, femur model of a patient is obtained with measuring the necessary measurements from the fewer number of 2D medical images obtained by more common methods such as x-ray images. To create modular blocks, another parametric algorithm was generated. Modules with different topological features can be created by changing the parameters in this algorithm as desired. Another algorithm has been developed where the created modular blocks are used as input and the tool path for the continuous extrusion AM is produced. As an output from this algorithm, a novel, zig-zag and spiral pattern to manufacture the modules was obtained as a G code file. As the last step, a system was developed that includes information on what the printed modules are. This system informs the clinician in the field about how many of which on-demand modules they could use to create a best fitting patient specific scaffold to represent the defect area of the patient. By following the instruction, the clinician puts the proper scaffold blocks on top of each other and implants the assembled scaffold structure on the body with the help of an intramedullary nail. This study represents a promising approach in the creation of a new customized best fitting scaffold with less time, money and effort for large bone defects.