摘要
目的:探讨天玑骨科机器人辅助下空心螺钉内固定对股骨颈骨折的临床疗效及优势。方法:回顾性分析2019年1月至2022年1月行空心螺钉内固定治疗的41例股骨颈骨折患者临床资料,按手术方式不同分为天玑机器人组18例及传统空心螺钉固定组(传统手术组)23例,其中天玑机器人组18例,男8例,女10例,年龄(56.00±4.22)岁,Garden分型Ⅰ型4例、Ⅱ型11例、Ⅲ型2例、Ⅳ型1例;传统手术组23例,男10例,女13例,年龄(54.87±4.81)岁,Garden分型Ⅰ型5例、Ⅱ型14例、Ⅲ型3例、Ⅳ型1例。观察比较两组患者手术时间、术中出血量、术中透视次数、导针放置次数、手术费用等指标。术后12个月采用Harris评分评估患者髋关节功能。结果:所有患者伤口甲级愈合,无并发症发生。两组患者手术时间、术中透视次数、导针放置次数、术中出血量、手术费用比较,差异均有统计学意义(P<0.05)。41例患者获得至少12个月随访,两组骨折均愈合。天玑机器人组随访期间无感染、螺钉松动、骨折移位,未发生股骨头坏死;传统手术组随访期间出现螺钉松动2例。术后12个月机器人组Harris髋关节功能评分中日常活动、跛行、关节活动度评分及总分均高于传统手术组(P<0.05)。结论:天玑机器人辅助下置钉是治疗股骨颈骨折的较好方法,提高手术效率,置钉更准确,一次性置钉成功率更高、手术时间短、辐射少,术后髋关节功能恢复更佳。
Objective To investigate the clinical efficacy and advantages of Tianji orthopedic robot assisted cannulated screw internal fixation for femoral neck fracture.Methods The clinical data of 41 patients with femoral neck fracture who underwent internal fixation with cannulated screws from January 2019 to January 2022 were retrospectively analyzed.According to different surgical methods,they were divided into Tianji robot group and traditional cannulated screw fixation group(traditional operation group).Among them,there were 18 patients in Tianji robot group including 8 males and 10 females with age of(56.00±4.22)years old,Garden typeⅠ(4 cases),typeⅡ(11 cases),typeⅢ(2 cases),and typeⅣ(1 case).There were 23 patients in the traditional operation group,including 10 males and 13 females,aged(54.87±4.81)years old;there were 5 cases of Garden typeⅠ,14 cases of typeⅡ,3 cases of typeⅢand 1 case of typeⅣ.The operation time,intraoperative blood loss,fluoroscopy times,guide needle placement times,operation costs and other indicators were observed and compared between two groups.Harris score was used to evaluate hip joint function 12 months after operation.Results The wounds of all patients healed in Grade A without complications.There were significant differences between two groups in terms of operation time,times of intraoperative fluoroscopy,times of guide needle placement,amount of intraoperative bleeding,and operation cost(P<0.05).All 41 patients were followed up for at least 12 months.The fractures of both groups were healed.There was no infection,screw loosening,fracture displacement and femoral head necrosis in Tianji robot group during follow-up;Screw loosening occurred in 2 patients in the traditional operation group during follow-up.At 12 months after operation,Harris hip joint function score of Tianji robot group was higher than that of traditional operation group in daily activity,lameness,joint activity score and total score(P<0.05).Conclusion Tianji robot assisted nail placement is a better method for the treatment of femoral neck fracture,which improves the surgical efficiency,is more accurate,has higher success rate of one-time nail placement,shorter operation time,less radiation,and has better hip joint function recovery after surgery.
作者
聂德新
孙文皋
王小强
王明俊
孙锦波
陈春
NIE De-xin;SUN Wen-gao;WANG Xiao-qiang;WANG Ming-jun;SUN Jin-bo;CHEN Chun(Orthopaedic Joints,Sports Medicine,Pediatric Orthopedics,Xingyi Hospital Affiliated to Guizhou Medical University,Xingyi 562400,Guizhou,China)
出处
《中国骨伤》
CAS
CSCD
2023年第3期221-225,共5页
China Journal of Orthopaedics and Traumatology
基金
贵州省黔西南州科技计划项目(编号:2021-1-11)。
关键词
骨科机器人
股骨颈骨折
空心螺钉
内固定
Orthopedic robot
Femoral neck fracture
Cannulated screw
Internal fixation
