应用天玑骨科机器人辅助经皮内固定治疗经舟骨月骨周围脱位的可行性观察  

Feasibility of the application of Tinavi-robot-assisted percutaneous internal fixation in the treatment of trans-scaphoid perilunate dislocation

作　　者：梁伟[1] 李青松[1] 季亮[1] 王祥[1] 胡兴峰[1] 张博伟 金鑫[1] 徐子航 Liang Wei;Li Qingsong;Ji Liang;Wang Xiang;Hu Xingfeng;Zhang Bowei;Jin Xin;Xu Zihang(Department of Hand Surgery,Guiyang Orthopaedic Hospital,the Fourth People's Hospital of Guiyang,Guiyang 550002,China)

机构地区：[1]贵州省贵阳市第四人民医院、贵阳市骨科医院手外科,550002

出　　处：《骨科临床与研究杂志》2023年第1期44-49,共6页Journal Of Clinical Orthopedics And Research

摘　　要：目的探讨应用天玑骨科机器人辅助经皮内固定治疗新鲜经舟骨月骨周围脱位的可行性。方法对2018年7月至2021年1月贵阳市第四人民医院手外科应用天玑骨科机器人辅助经皮内固定治疗的新鲜经舟骨月骨周围脱位患者5例的临床资料进行回顾性分析。其中男4例,女1例;年龄(34.2±6.8)(27~45)岁。对5例患者均行急诊手法复位和石膏夹板外固定后择期手术治疗。采用Mayo腕关节功能评分、腕关节活动度和VAS评分对腕关节功能和疼痛程度进行评价。结果5例手术均顺利完成,无重复穿针。手术(含术中规划)时间(58.0±8.2)(45~65)min。置钉误差(0.4±0.1)(0.5~0.7)mm。随访时间为(14.4±1.7)(12~16)个月。末次随访时,5例患者伤口均一期愈合;均在术后12周拆除克氏针,未发生感染;腕关节活动度为屈曲(74.0°±8.2°)(65°~83°)、背伸(62.0°±11.7°)(53°~71°)、尺偏(41.0°±2.4°)(38°~44°)和桡偏(20.0°±4.1°)(15°~25°),握力恢复至(29.8±1.2)(26.2~32.5)kgf,平均恢复至健侧的82.5%(65.2%~92.6%),捏力恢复至(16.7±1.9)(14.3~20.5)kgf,平均恢复至健侧的80.2%(67.9%~89.1%);Mayo腕关节功能评分为(83.5±1.7)(80~89)分;腕关节VAS评分为(3.0±0.7)(2~4)分。结论采用天玑骨科机器人辅助经皮螺钉和克氏针固定治疗新鲜经舟骨月骨周围脱位,可获得令人满意的效果,有可行性。Objective To investigate the feasibility of applying Tinavi-robot-assisted percutaneous internal fixation for the treatment of transscaphoid perilunate dislocation.Methods Clinical data of 5 patients with fresh transscaphoid perilunate dislocation underwent Tinavi-robot-assisted percutaneous internal fixation in the Department of Hand Surgery,Guiyang Orthopaedic Hospital from July 2018 to January 2021 were analyzed retrospectively.There are 4 males and one females aged(34.2±6.8)(27-45)years.All the 5 cases were treated with date surgery after emergency manual reduction and external fixation with a plaster splint.The Mayo wrist function score,range of motion(ROM)and visual analogue scale(VAS)were used to evaluate the wrist function.Results All 5 surgeries were completed successfully without repeated fixation.The operative(including intraoperative planning)time was(58.0±8.2)(45-65)min.The screw setting error was(0.4±0.1)(0.2-0.6)mm.The follow-up period was(14.4±1.7)(12-16)months.At the last follow-up,all the wounds healed primarily.All Kirschner wires were removed 12 weeks after surgery and no infection were found.ROM of wrist was(74.0°±8.2°)(65°-83°)in flexion,(62.0°±11.7°)(53°-71°)in dorsiflexion,(41.0°±2.4°)(38°-44°)in ulnar deviation and(20.0°±4.1°)(15°-25°)in radial deviation.Grip strength of affected wrist recovered to(29.8±1.2)(26.2~32.5)kgf and 82.5%(65.2%-92.6%)of the healthy side,pinch strength recovered to(16.7±1.9)(14.3~20.5)kgf and 80.2%(67.9%-89.1%)of the healthy side.Mayo wrist function scores and the VAS scores of affected wrist were(83.5±1.7)(80~89)and(3±0.7)(2-4)scores,respectively.Conclusion It is feasible to apply Tinavi-robot-assisted percutaneous screw and Kirschner wire fixation in the treatment of fresh transscaphoid perilunate dislocation and satisfactory outcome can be obtained.

关 键 词：舟骨 月骨 骨折脱位 机器人手术 骨折固定术 内 

分 类 号：R687.3[医药卫生—骨科学]