天玑骨科机器人联合O臂导航系统微创治疗后足骨折的近期疗效  

Short-term effectiveness of TiRobot combined with O-arm navigation system in minimally invasive treatment of hindfoot fracture

作　　者：文泓泉 王鹏飞[1] 付亚辉[1] 魏星[1] 魏巍[1] 雷金来[1] 王虎[1] 温世明 张堃[1] 周凤金 庄岩[1] WEN Hongquan;WANG Pengfei;FU Yahui;WEI Xing;WEI Wei;LEI Jinlai;WANG Hu;WEN Shiming;ZHANG Kun;ZHOU Fengjin;ZHUANG Yan(Department of Orthopaedic Trauma,Honghui Hospital of Xi’an Jiaotong University,Xi’an Shaanxi,710054,P.R.China)

机构地区：[1]西安交通大学附属红会医院创伤骨科,西安710054

出　　处：《中国修复重建外科杂志》2022年第8期951-956,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的 探讨天玑骨科机器人联合O臂导航系统微创治疗后足骨折的近期疗效。方法 2019年3月—2021年3月,收治25例后足骨折患者。其中,男14例,女11例;年龄19~76岁,平均51.7岁。致伤原因:高处坠落伤17例,交通事故伤8例。受伤至手术时间1~3 d,平均2.1 d。单纯跟骨骨折16例,单纯距骨骨折7例,跟骨合并距骨骨折2例;其中,Sanders分型Ⅱ型10例、Ⅲ型8例,Hawkins分型Ⅱ型4例、Ⅲ型5例。术前美国矫形足踝协会(AOFAS)踝-后足评分为(48.1±9.1)分。术中于天玑骨科机器人联合O臂导航系统辅助下行经皮空心螺钉内固定骨折。记录手术时间、住院时间以及相关并发症发生情况;X线片复查评估骨折愈合情况及有无距骨坏死发生,测量跟骨宽度、长度、高度、B?hler角和Gissane角;采用AOFAS踝-后足评分评价足功能。结果 手术时间47~71 min,平均60.5 min;住院时间2~5 d,平均3.4 d。切口均Ⅰ期愈合。患者均获随访,随访时间12~24个月,平均17.3个月。术后1例患者出现足外侧皮肤感觉减退,对症处理后恢复正常。X线片复查示骨折均愈合,愈合时间10~16周,平均11.8周;随访期间无距骨坏死发生。末次随访时跟骨高度、宽度、长度、B?hler角及Gissane角与术前比较,差异均有统计学意义(P<0.05)。末次随访时,AOFAS踝-后足评分为(91.2±5.0)分,与术前比较差异有统计学意义(t=22.169,P<0.001);获优16例、良9例,优良率100%。结论天玑骨科机器人联合O臂导航系统微创治疗后足骨折,近期疗效满意,具有手术创伤小、精确固定、并发症少的优点。Objective To investigate the short-term effectiveness of TiRobot combined with O-arm navigation system in the minimally invasive treatment of hindfoot fracture. Methods Between March 2019 and March 2021, 25patients with hindfoot fractures were admitted. There were 14 males and 11 females, with an average age of 51.7 years(range, 19-76 years). The causes of injuries included falling from height in 17 cases and traffic accident in 8 cases. The interval between injury and operation was 1-3 days(mean, 2.1 days). There were 16 cases of calcaneus fracture, 7 cases of talus fracture, and 2 cases of calcaneus and talus fractures. According to Sanders classification criteria, the calcaneus fractures were classified as type Ⅱ in 10 cases and type Ⅲ in 8 cases;according to the Hawkins classification criteria, the talus fractures were classified as type Ⅱ in 4 cases and type Ⅲ in 5 cases. Preoperative American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score was 48.1±9.1. During operation, the fractures were fixed with the percutaneous cannulated screws with the assistance of the TiRobot combined with the O-arm navigation system. The operation time, hospital stay, and the occurrence of related complications were recorded. X-ray films were reviewed to evaluate the fracture healing and the occurrence of talus osteonecrosis, and the width, length, height, B?hler’s angle, and Gissane’s angle of the calcaneus were measured;AOFAS ankle-hindfoot score was used to evaluated the foot function.Results The operation time ranged from 47 to 71 minutes(mean, 60.5 minutes). The length of hospital stay ranged from2 to 5 days(mean, 3.4 days). All incisions healed by first intention. All patients were followed up 12-24 months(mean,17.3 months). One patient demonstrated hypoesthesia on the lateral side of foot after operation and recovered after symptomatic treatment. All fractures healed confirmed by X-ray films and the healing time ranged from 10 to 16 weeks(mean, 11.8 weeks). No talus osteonecrosis occurred during

关 键 词：天玑骨科机器人 O臂导航系统 跟骨骨折 距骨骨折 微创手术 

分 类 号：R687.3[医药卫生—骨科学]