摘要
为了探讨关节镜辅助复位结合机器人导航置钉对距骨颈骨折的疗效, 回顾性分析2018年1月至2021年1月13例因距骨颈骨折在徐州仁慈医院治疗的患者的临床资料。其中, 男9例, 女4例, 年龄(36±12)岁;右侧8例, 左侧5例。患者均在关节镜下复位, 结合骨科机器人三维导航定位置入空心螺钉。术后随访观察伤口及并发症, 末次随访测量双侧踝关节背伸跖屈活动度, 术前与末次随访患足疼痛视觉模拟评分(VAS)。采取美国足与踝关节协会(AOFAS)踝与后足功能量表进行踝关节功能评分。结果发现, 13例患者伤口均一期愈合, 手术时间(95±45)min, 出血量(45±10)ml。患者获得(15.0±3.5)个月的随访。其中2例出现距下关节炎, 未出现距骨坏死及骨折不愈合情况。末次随访测量双侧踝关节背伸活动度:患侧为25.8°±1.9°, 与健侧(26.2°±2.3°)相比, 差异无统计学意义(P=0.316);双侧踝关节跖屈活动度:患侧为44.2°±2.7°, 与健侧(44.7°±2.8°)相比, 差异无统计学意义(P=0.323)。末次随访时患足疼痛VAS评分为(0.53±0.18)分, 与术前[(0.87±0.29)分]相比, 差异有统计学意义(P<0.001)。末次随访时踝关节功能AOFAS评分平均为93.5分。本研究表明, 关节镜辅助复位结合机器人导航置钉治疗距骨颈骨折效果满意, 值得临床推广。
This study aims to explore the clinical efficacy of arthroscopic-assisted reduction combined with robot-navigated nail placement in the treatment of talar neck fractures.The clinical data of 13 patients with talar neck fracture in Xuzhou Benevolent Hospital from January 2018 to January 2021 were analyzed in the retrospective study.Among them,there were 9 males and 4 females,aged(36±12)years;there were 8 cases suffered on the right and 5 cases on the left.All patients were reset under arthroscopy and cannulated screws were placed in combination with three-dimensional navigation and positioning of orthopedic robot.The wounds and complications were observed in the postoperative follow-up.The activities of bilateral ankle dorsiflexion and plantar flexion were measured in the last follow-up.The visual analogue scale score(VAS)of pain in the affected feet before operation were compared with that at the last follow-up.The ankle and hind foot work energy scale of American Foot and Ankle Association(AOFAS)was used to assess the ankle function.The results showed that the wounds of 13 patients healed in one stage.The operation time was(95±45)min and the blood lose was(45±10)ml.All the patients were followed-up for(15.0±3.5)months.Two cases developed subtalar arthritis without talus necrosis and fracture nonunion.At the last follow-up,there was no significant difference in the dorsal extension and plantar flexion of the ankle between the affected side and the healthy side(25.8°±1.9°vs 26.2°±2.3°,44.2°±2.7°vs 44.7°±2.8°,both P>0.05).The VAS score of pain in the affected foot at the last follow-up was 0.53±0.18,it was significantly lower than that before operation(0.87±0.29)(P<0.001).The mean AOFAS ankle and hind foot energy scale of the ankle function was 93.5 at the last follow-up.It′s showed that treatment of talus neck fracture with arthroscopy assisted and robot guided nail placement is satisfactory and is worthy of clinical promotion.
作者
徐明亮
石荣剑
陈国梁
娄理想
李翠华
Xu Mingliang;Shi Rongjian;Chen Guoliang;Lou Lixiang;Li Cuihua(Department of Foot and Ankle Surgery,Xuzhou Renci Hospital,Xuzhou 221004,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2022年第19期1472-1475,共4页
National Medical Journal of China
关键词
关节镜
机器人
距骨颈骨折
置钉
随访
Arthroscopy
Robot
Talar neck fracture
Nail placement
Follow-up
