双平面机器人导航辅助下空心钉内固定治疗股骨颈骨折  

Bi-planar robot navigation for cannulated screw fixation in the treatment of femoral neck fractures

作　　者：黄波 荣绍远 李建华 王现海 危杰[2] 赵春鹏[2] 周利[2] 王军强[2] 王满宜[2] 

机构地区：[1]北京昌平医院骨科,102200 [2]北京积水潭医院创伤骨科,100035

出　　处：《中华骨科杂志》2017年第9期528-534,共7页Chinese Journal of Orthopaedics

基　　金：国家科技支撑计划课题（2011BAF01803）

摘　　要：目的探讨双平面机器人导航辅助下空心钉内固定治疗股骨颈骨折的临床疗效。方法回顾性分析2011年5月至2015年5月采用空心钉内固定治疗86例股骨颈骨折患者资料，根据术中是否应用双平面机器人导航辅助内固定分为2组：导航辅助手术组及非导航辅助手术组。按照患者性别、年龄、骨折Garden分型的对应关系进行配对入组，共64例患者纳入研究。导航辅助手术组32例，男10例，女22例；年龄51-68岁，平均（59．4±5．6）岁；Garden分型：Ⅰ型1例，Ⅱ型7例，Ⅲ型14例，Ⅳ型10例。导航非辅助手术组32例，男12例，女20例；年龄53-70岁，平均（59．1±4．9）岁；Garden分型：Ⅰ型1例，Ⅱ型5例，Ⅲ型18例，Ⅳ型8例。64例患者均采用空心钉内固定。对两组患者术中X线透视时间、透视次数、导针钻孔次数、空心钉置入后更换次数、空心钉置入时间、出血量、术后正侧位X线片上任意两枚空心钉之间的角度及每枚空心钉与股骨颈轴线之间的角度、骨折愈合时间、功能评分等指标进行比较。结果导航辅助手术组及非导航辅助手术组患者术中X线透视时间分别为平均（10．1±2．9）s和（36．8±7．5）s，透视次数分别为平均（11．4±3．2）次和（43．9±11．0）次，导针钻孔次数分别为平均（3．9±1．1）次和（18．5±3．2）次，空心钉置入后更换次数分别平均为（0．4±0．6）次和（1．0±0．7）次，出血量分别平均为（29．4±14．7）ml和（50．2±17．1）ml，空心钉置入时间分别平均为（28．8±7.3）min和（43．8±7．9）min，术后正侧位X线片上空心钉之间的角度分别平均为：正位3．1°±1．1°和7．3°±1．2°，侧位2．9°±1．0°和4．4°±2．3°，空心钉与股骨颈轴线之间的角度分别平均为：正位4．4°±1．6°和7．5°±1．70、侧位4．9°±1．6°和8．0°±1．3°，以上项目两组间比较差异均有统�Objective To investigate the clinical results of Bi-plane robot navigation for eannulated screw fixation in the treatment of femoral neck fractures. Methods Between May 2011 and May 2015, 86 patients with femoral neck fracture who were fixed with eannulated screws were retrospectively analyzed. The patients were divided into navigation group and non-naviga- tion group according to whether the Bi-planar robot used for navigation or not. The patients were matched concerning gender, age and Garden classification. A total of 64 patients were included in the study. In navigation group, there were 32 cases, including 10 males and 22 females. The average age was 59.4±5.6 yr （range, 51-68 yr）. According to Garden classification, there were 1 case of type Ⅰ, 7 cases of type Ⅱ, 14 cases of type Ⅲ and 10 cases of type Ⅳ. In non-navigation group, there were 32 cases, including 12 males and 20 females. The average age was 59.1±4.9 yr （range, 53-70 yr）. According to Garden classification, there were 1 case of type I, 5 cases of type IL-18 cases of type III and 8 cases of type IV. Sixty-four cases were all fixed with eannulated screws. The flu- oroscopy time, fluoroscopy times, drilling times, times of eannulated screw replacement, cannulated screw insertion time, blood loss, relative position between any two eannulated screws in postoperative AP view and lateral view, the angle between each cannu- lated screw and the femoral neck axis, fracture healing time and functional score were recorded. Results The parameters in navi- gation group versus non-navigation group were as follows： the average fluoroscopy time was 10.1±2.9 s vs 36.8±7.5 s, the averagefluoroscopy times was 11.4±3.2 vs 43.9±11.0, the average drilling times was 3.9± 1.1 vs 18.5±3.2, the average times of cannulated screw replacement was 0.4±0.6 vs 1.0±0.7; the average blood loss was 29.4±14.7 ml vs 50.2±17.1 ml, eannulated screws place- ment time averaged 28.8±7.3 min vs 43.8±7.9 min. The angle between any of two eannulated screws av

关 键 词：机器人 外科手术 计算机辅助 股骨颈骨折 内固定器 

分 类 号：R687.3[医药卫生—骨科学] TP242[医药卫生—外科学]