机器人导航辅助经皮空心钉内固定治疗股骨颈骨折的临床疗效评价  

Clinical effect evaluation of robot navigation for percutaneous cannulated screw fixation in treatment of femoral neck fractures

作　　者：易少华 张德华[1] 王健[1] 夏海军 巴雪峰[1] 赵建新[1] 廖燚[1] YI Shao-hua;ZHANG De-hua;WANG Jian;XIA Hai-jun;BA Xue-feng;ZHAO Jian-xin;LIAO Yi(Department of Orthopaedics,Kramaj Central Hospital,Karamay,Xingjiang 834000,China)

机构地区：[1]克拉玛依市中心医院骨科,新疆834000

出　　处：《中国骨与关节损伤杂志》2022年第4期337-341,共5页Chinese Journal of Bone and Joint Injury

基　　金：克拉玛依市级科技备案项目(JK2016-4)。

摘　　要：目的评价骨科机器人辅助经皮空心钉内固定治疗股骨颈骨折的临床疗效。方法前瞻性随机对照研究自2017-04—2020-04采用闭合复位3枚空心钉内固定治疗的68例股骨颈骨折,32例采用骨科机器人辅助置钉(观察组),36例徒手置钉(对照组)。比较两组手术操作时间、操作调校时间、X线辐射量,术后正侧位X线片上空心钉之间的夹角、空心钉与股骨颈轴线的夹角,以及骨折愈合时间、末次随访时髋关节功能Harris评分。结果68例均获得随访,随访时间平均18(12~24)个月。观察组手术操作时间、操作调校时间较对照组短,X线辐射量较对照组少,术后正侧位X线片上空心钉之间的夹角、空心钉与股骨颈轴线的夹角均小于对照组,差异有统计学意义(P<0.05)。观察组与对照组的骨折愈合时间、末次随访时髋关节功能Harris评分比较差异无统计学意义(P>0.05)。结论股骨颈骨折闭合复位经皮空心钉内固定术中应用骨科机器人可以缩短有创操作手术时间,减少导针调整次数与X线辐射量,空心钉置入更加精准且空心钉空间分布更合理。Objective To evaluate the clinical results of robot navigation for percutaneous cannulated screw fixation in the treatment of femoral neck fractures.Methods A prospective randomized controlled study were performed on 68 cases of femoral neck fractures treated by closed reduction with 3 cannulated screw fixation from April 2017 to April 2020.In observation group,cannulated screws were inserted in 32 cases with robot navigation.In the control group,cannulated screws were inserted in 36 patients without robot navigation.The operation time,operation adjustment time,intraoperative ray quantity,angle of insertion of hollow nail,fracture healing time,Harris score of hip joint at last the follow-up in two groups were analyzed and compared.Results All 68 patients were followed up for 12-24 months(mean 18 months).The operation time and adjustment time of the observation group were shorter than those of the control group,the X-ray radiation amount were less than that of the control group,and the angle between the screw and the femoral neck axis on the postoperative positive and lateral X-ray film was smaller than that of the control group,the differences were statistically significant(P<0.05).There were no significant differences in fracture healing time and Harris score of hip function at the last follow-up between the observation group and the control group(P>0.05).Conclusion The application of orthopedic robot navigation in closed reduction percutaneous hollow screw internal fixation of femoral neck fractures can shorten the operation time,reduce the number of guide wire adjustment and X-ray radiation,and the placement of hollow screw is more accurate and the spatial distribution of hollow screw is more reasonable.

关 键 词：股骨颈骨折 空心钉 内固定 机器人 计算机导航 

分 类 号：R687.3[医药卫生—骨科学]