撬拨复位结合机器人导航下空心螺钉内固定治疗难复性股骨颈骨折的疗效观察  

Curative Effect Observation of Percutaneous Cannulated Screws Fixation Assisted by Robot Navigation and Poking Rduction Technique for Femoral Neck Fractures

作　　者：石维祥 罗晓中[2] 童祎[2] 吴刚[2] 周欣[2] 

机构地区：[1]西南医科大学临床医学院,四川泸州646000 [2]自贡市第四人民医院骨科,四川自贡643000

出　　处：《实用骨科杂志》2017年第2期114-117,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨撬拨复位结合机器人导航下空心螺钉内固定治疗难复性股骨颈骨折的临床疗效。方法收集我科自2013年5月至2015年6月撬拨复位结合机器人导航下经皮空心螺钉内固定治疗的13例难复性股骨颈骨折患者临床资料,其中男8例,女5例;年龄36~59岁,平均47.3岁。致伤原因:交通事故伤8例,跌伤2例,高处坠落伤3例。左侧7例,右侧6例。Garden分型Ⅲ型9例,Ⅳ型4例。记录手术时间、导针置入次数、术中透视时间、术中出血量、骨折愈合率及股骨头坏死情况、采用Garden对线指数评价股骨颈骨折复位质量、髋关节功能Harris评分评价髋关节功能。结果所有患者术后均获随访,随访时间12~25个月,平均(18.6±6.6)个月。手术时间平均(92.2±6.7)min,术中透视时间平均(16.1±4.1)s,导针置入次数平均(5.2±1.2)次,出血量平均(10.1±2.1)mL,Garden指数:正位(173.3±8.3)°,侧位(171.1±11.1)°,骨折愈合率100%,骨折平均愈合时间(5.8±1.3)个月,术后髋关节Harris评分(86.9±5.1)分,末次随访时所有患者均未见骨折不愈合和股骨头坏死情况发生。结论撬拨复位结合机器人导航下空心螺钉固定术复位质量高、螺钉置入精度高、手术创伤小、术后髋关节功能恢复好,是治疗难复性股骨颈骨折较为理想的方法。Objective To discuss the effect of fixation with percutaneouscannulated screws assisted by robot navigation and poking reduction technique for femoral neck fractures.Methods From May 2013 to June 2015,13 patients with femoral neck fracture were treated by internal fixation with percutaneouscannulated screws assisted by robot navigation and poking reduction technique.Record the operation time,X-ray fluoroscopy time,blood loss,total drilling times,the parallel degree of screws,the healing rate of fractures,the Harris scores of all patients.Results All patients were followed up for 12-25months with an average of（18.6±6.6）months.Average operation time was（92.2±6.7）min.Average frequency of guide pin insertion was（5.2±1.2）times,X-ray fluoroscopy time was（16.1±4.1）s,blood loss was（10.1±2.1）mL.Garden index was（173.3±8.3）°in AP view and（171.1±11.1）°in the lateral.The X ray showed that the fracture healing rate was 100 percent.The verage healing time was（5.8±1.3）months,Postoperative Harris hip score was（86.9±5.1）.The latest follow-up revealeds that none nonunion of fracture or femoral head necrosis was founded in the all patients.Conclusion Cannulated screw fixation assisted by robot navigation and poking reduction technique has high clinical application value.Which lead to more accurate positioning,better hip function,less surgical trauma and X-ray exposure times.It is a good method to treat femoral neck fractures.

关 键 词：撬拨复位 机器人导航 股骨颈骨折 空心拉力螺钉 内固定 

分 类 号：R683.42[医药卫生—骨科学]