摘要
目的 观察骨科手术机器人辅助空心螺钉经皮微创内固定治疗青壮年股骨颈骨折的效果。方法 选取百色市人民医院2018年5月~2022年3月期间采用骨科机器人导航辅助下行空心钉内固定的24例股骨颈骨折患者作为机器人辅助组,同期采用传统徒手定位内固定的30例股骨颈骨折患者作为徒手对照组。比较两组患者手术时间、术中失血量、术中透视、导针定位次数等术中指标及住院时长、骨折愈合时间、术后并发症。比较两组患者末次随访时Harris评分。根据两组患者术后即时的正侧位片,测量计算3根螺钉之间及与空心钉股骨颈轴线的正侧位夹角。结果 机器人辅助组术中透视次数(15.2±3.9)次、透视时间(13.8±3.1)s、导针定位次数(4.7±2.1)次、出血量为(30.9±14.2)ml,均低于徒手对照组的(40.6±11.3)次、(32.7±9.1)s、(17.4±4.9)次、(52.1±13.6)ml,差异有统计学意义(t=10.506、9.718、11.539、5.582,P<0.05)。机器人辅助组手术时间(73.5±11.8)min、住院时间(8.1±2.4)d、骨折愈合时间(5.3±2.2)月、末次随访Harris评分(86.5±3.7)分、并发症发生率0.0%,与对照组的(68.3±9.4)min、(7.6±2.8)d、(5.8±2.1)月、(87.8±4.1)分、3.33%比较,差异无统计学意义(t=1.803、0.694、0.851、1.208、0.012,P> 0.05);机器人辅助组正侧位空心钉之间夹角、空心钉与股骨颈轴线夹角(1.3±1.1)°、(2.2±1.2)°、(2.7±1.5)°、(3.8±1.4)°均低于徒手对照组的(6.5±1.8)°、(5.7±2.0)°、(7.4±1.9)°、(7.9±1.3)°,差异有统计学意义(t=12.407、7.547、9.894、7.663,P<0.05)。结论 机器人导航定位辅助下空心钉内固定治疗青壮年股骨颈骨折,空心钉定位精准,能显著减少导针调整次数,减少术中透视次数及透视时间,创伤更小。
Objective To observe the effect of minimally invasive percutaneous internal fixation with cannulated screws assisted by an orthopedic surgical robot in treating femoral neck fractures in young and middle-aged patients.Methods Between May 2018 and March 2022,24 patients with femoral neck fractures who underwent hollow nail internal fixation using orthopedic robot navigation assistance were collected as the robot assisted group,while 30 patients who received traditional barehanded positioning and internal fixation during the same period were selected as the barehanded control group.Intraoperative parameters including surgical duration,intraoperative blood loss,intraoperative fluoroscopy,and number of needle positioning times,as well as hospital stay,fracture healing time,and postoperative complications were compared.Additionally,Harris score at the last follow-up were compared between the groups.The angle between the three screws and the femoral neck axis was measured based on the immediate anteroposterior and lateral radiographs post surgery.Results The intraoperative fluoroscopy frequency(15.2±3.9)times,fluoroscopy time(13.8±3.1)s,needle positioning frequency(4.7±2.1)times,and bleeding volume(30.9±14.2)ml in the robot assisted group were lower than those in the bare handed control group(40.6±11.3)times,(32.7±9.1)s,(17.4±4.9)times,and(52.1±13.6)ml,with statistically significant differences(t=10.506,9.718,11.539,5.582,P<0.05).The robot assisted group had surgery time of(73.5±11.8)minutes,hospital stay of(8.1±2.4)days,fracture healing time of(5.3±2.2)months,Harris score of last follow-up(86.5±3.7)points,and complication incidence rate of 0.0%.There was no statistically significant difference compared to the control group′s(68.3±9.4)minutes,(7.6±2.8)days,(5.8±2.1)months,(87.8±4.1)points,and 3.33%(t=1.803,0.694,0.851,1.208,0.012,P>0.05).The angle between the anterior and lateral hollow screws in the robot assisted group,the angle between the hollow screw and the femoral neck axis(1.3±1.1)°,(2.2±1.
作者
梁善校
许鹏雍
班付伟
黎承伟
黄志鹏
陈仕
Liang Shanxiao;Xu Pengyong;Ban Fuwei(Department of Trauma Orthopedics,Baise People′s Hospital,Baise 533000,China)
出处
《中华保健医学杂志》
2024年第3期356-359,共4页
Chinese Journal of Health Care and Medicine
基金
广西壮族自治区卫健委自筹经费科研课题(Z-L20221846)。
关键词
手术机器人
空心螺钉
内固定
股骨颈骨折
Surgical robot
Cannulated screw
Internal fixation
Femoral neck fracture
