机器人辅助经皮螺钉内固定结合三维打印模板治疗腕舟骨骨折一例报告  

Robot assisted screw fixation combined with 3D mould for carpal scaphoid fracture: A case report

作　　者：郭阳[1] 钟文耀 刘坤[1] 童德迪[1] 殷耀斌[1] 杨辰[1] Guo Yang;Zhong Wenyao;Liu Kna;Tong Dedi;Yin Yaobin;Yang Chen(Department of Hand Surgery,Bering Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院手外科,北京100035

出　　处：《骨科临床与研究杂志》2018年第4期209-212,217,共5页Journal Of Clinical Orthopedics And Research

基　　金：北京市卫生系统高层次人才培养计划(2015-3-035)~~

摘　　要：目的评价骨科手术机器人结合三维打印模板辅助经皮螺钉内固定治疗急性腕舟骨骨折的可行性。方法 2018年3月北京积水潭医院对1例急性无明显移位腕舟骨骨折患者,在骨科手术机器人辅助下实施了闭合复位经皮螺钉内固定手术。术中采用个性化设计的三维打印模板固定患肢。记录手术时间、术中X线暴露时间、导针置入的调整次数以及不良事件的发生情况。术后进行随访,通过X线观察骨折愈合情况,同时观察患者腕关节活动度并记录患者主观感觉。结果本研究病例的手术时间为58 min,X线曝光时间为18.4 s。导针置入1次完成,没有进行调整,所置入螺钉在腕舟骨内居中。随访期间未见相关并发症。术后4周腕关节活动度达到正常范围的80%,患者无明显不适感。结论骨科手术机器人结合三维打印模板辅助腕舟骨骨折的经皮螺钉内固定治疗可行,其置钉的精确度和安全性的初步结果良好,有一定的临床应用前景。Objective To evaluate the feasibility of carpal scaphoid screw guide wire placement using robot assist system combined with 3 D mould. Methods One patient with acute non-displaced carpal scaphoid fracture was treated by robot assisted carpal scaphoid screw fixation combined with 3 D mould and followed up.The total operation time,fluoroscopic time and times of guide wire inserting attempt were recorded. Postoperative complication was also documented. Results Duration of the surgery was 58 min and fluoroscopy time was18. 4 s. No repeated drilling to the carpal scaphoid was needed in this case. The screw was considered to be centrally placed in the carpal scaphoid and no complication was noted. The motion of the wrist returned to 80%of the normal range at 4 weeks after surgery. And the patient reported no apparent discomfort. Conclusion The application of robotic system to assist placement of screw guide wire combined with 3 D mould for acute carpal scaphoid fracture showed acceptable accuracy. This technique may provide a simple and effective method for the guidance of screw guide wire insertion in a surgery for non-displaced carpal scaphoid fracture.

关 键 词：舟骨 腕 骨折 骨折固定术 内 机器人 

分 类 号：R687.3[医药卫生—骨科学]