TiRobot骨科机器人导航外固定支架固定在肘关节松解术中的应用效果分析  

TiRobot navigation for hinged external fixation in elbow arthrolysis

作　　者：查晔军[1] 肖丹 花克涵 孙伟桐 公茂琪[1] 陈辰[1] 蒋协远[1] Zha Yejun;Xiao Dan;Hua Kehan;Sun Weitong;Gong Maoqi;Chen Chen;Jiang Xieyuan(Department of Traumatology and Orthopedics,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院创伤骨科,北京100035

出　　处：《中华创伤骨科杂志》2022年第2期100-106,共7页Chinese Journal of Orthopaedic Trauma

基　　金：北京市自然科学基金-海淀原始创新联合基金(L192049);北京市卫生健康委员会第三批公益性科研试点项目(BMHC2019-9);北京积水潭医院高层次人才"学科骨干"培养计划(XKGG202101)。

摘　　要：目的探讨TiRobot骨科机器人导航外固定支架固定在肘关节松解术中的应用效果。方法回顾性分析2018年4月至2019年8月于北京积水潭医院创伤骨科术中使用TiRobot机器人导航辅助肘关节外固定支架固定治疗11例因肘关节僵硬行肘关节松解术的患者资料。男9例,女2例;年龄21~66岁,平均39.3岁;记录患者末次随访时肘关节活动度并与术前进行比较,同时记录疼痛视觉模拟评分(VAS)、Mayo肘关节功能评分(MEPS)及并发症发生情况。结果11例患者术中机器人导航辅助下定位肘关节旋转中心轴,入点偏差平均0.21 mm(0.05~0.41 mm),出点偏差平均0.23 mm(0.06~0.38 mm)。术后所有患者获平均25.8个月(16~32个月)随访。末次随访时11例患者屈伸、旋转活动度分别为133.0°(134.9°,138.7°)、164.6°±17.5°,均较术前[0.8°(0°,33.7°)、122.9°±49.0°]显著提高,差异均有统计学意义(P<0.05)。末次随访时VAS评分平均为0.2分(0~1分),MEPS评分平均为96.8分(85~100分),其中9例为优,2例为良。无患者出现桡神经损伤、固定针松动或断裂、针道感染、固定针周围骨折等并发症。结论肘关节松解术中行TiRobot骨科机器人导航辅助肘关节外固定支架固定,旋转中心轴定位精确,患者能获得较为满意的功能预后。Objective To investigate the efficacy of TiRobot navigation for hinged external fixation in elbow arthrolysis.Methods The 11 patients were retrospectively analyzed who had been treated by elbow arthrolysis at Department of Traumatology and Orthopedics,Beijing Jishuitan Hospital using TiRobot navigation for hinged external fixation.There were 9 males and 2 females with a mean age of 39.3 years(from 21 to 66 years).Their elbow range of motion(ROM)was compared between preoperation and the final follow-up.Their visual analogue scale(VAS)and Mayo elbow performance score(MEPS)and complications were documented at the final follow-up.Results The rotation axis of the elbow joint was positioned with the aid of intraoperative robot navigation in 11 patients.The deviation of entry point averaged 0.21 mm(from 0.05 to 0.41 mm)and the deviation of exit point 0.23 mm(from 0.06 to 0.38 mm).The follow-up time for the 11 patients averaged 25.8 months(from 16 to 32 months).Their elbow flexion and extension was 133.0°(134.9°,138.7°)and rotation 164.6°±17.5°at the final follow-up,significantly improved compared with their preoperative values[0.8°(0°,33.7°)and 122.9°±49.0°](P<0.05).Their VAS averaged 0.2(from 0 to 1)and MEPS 96.8(from 85 to 100)at the final follow-up,giving 9 excellent and 2 good cases.There was no case of radial nerve injury,pin instability,pin breakage,pin infection or peri-pin fracture.Conclusion When TiRobot navigation is used for hinged external fixation in elbow arthrolysis,the axis of rotation can be accurately located,leading to satisfactory functional outcomes for the patients.

关 键 词：机器人 肘关节 外固定器 关节不稳定性 肘关节松解术 

分 类 号：R687.3[医药卫生—骨科学]