骨科手术机器人辅助双平面双支撑螺钉固定治疗中青年股骨颈骨折的疗效分析  

TiRobot-assisted biplane double-supported screw fixation for femoral neck fractures in middle-aged and young patients

作　　者：廖永成 张明[1] 徐俊华 张奕[1,2] Liao Yongcheng;Zhang Ming;Xu Junhua;Zhang Yi(Department of Traumatic Orthopaedics,Puren Hospital,Wuhan University of Science and Technology,Wuhan 430081,China;Medical College,Wuhan University of Science and Technology,Wuhan 430072,China)

机构地区：[1]武汉科技大学附属普仁医院创伤骨科,武汉430081 [2]武汉科技大学医学院,武汉430072

出　　处：《中华创伤骨科杂志》2022年第12期1069-1074,共6页Chinese Journal of Orthopaedic Trauma

基　　金：湖北省卫生健康科研基金(WJ2018H0093);武汉市卫生健康委员会科研项目(WX20B19);武汉科技大学职业危害识别与控制湖北省重点实验室开放基金(OHIC2020Z02)。

摘　　要：目的探讨骨科手术机器人辅助下使用双平面双支撑螺钉固定治疗中青年股骨颈骨折的疗效。方法回顾性分析武汉科技大学附属普仁医院创伤骨科2021年1月至2022年1月期间采用双平面双支撑螺钉(F螺钉)固定治疗的28例中青年股骨颈骨折患者资料。根据术中是否使用机器人辅助置钉分为两组(n=14):观察组男6例, 女8例;年龄为(44.1±8.7)岁;采用天玑Ⅱ骨科手术机器人辅助置钉。对照组男7例, 女7例;年龄为(48.8±8.0)岁;采用传统方法在C型臂X线机透视下置钉。比较两组患者的手术时间、术中透视次数、术中出血量、住院时间、骨折愈合时间、术后并发症发生情况及术后6个月患髋功能等。结果两组患者术前一般资料的比较差异均无统计学意义(P> 0.05), 具有可比性。观察组患者的手术时间[(66.5±3.7)min]和住院时间[(9.4±1.2)d]显著短于对照组患者[(77.1±3.9)min、(11.3±1.2)d],术中透视次数[(12.8±1.6)次]、术中出血量[3.5(2.8, 4.0) mL]显著少于对照组患者[(18.7±2.5)次、26.0(24.0,27.3) mL], 差异均有统计学意义(P< 0.05)。随访期间两组患者骨折均愈合良好, 无明显并发症发生, 观察组患者骨折愈合时间[(6.1±1.2)个月]短于对照组患者[(6.3±1.1)个月], 但差异无统计学意义(P>0.05)。术后6个月观察组患者的髋关节Harris评分[(92.6±2.7)分]显著高于对照组患者[(90.6±1.9)分], 差异有统计学意义(P< 0.05)。结论与传统C型臂X线机透视下置钉相比, 天玑Ⅱ骨科机器人辅助下双平面双支撑螺钉固定治疗中青年股骨颈骨折, 可以缩短患者的手术时间和住院时间, 减少患者术中透视次数和术中出血量, 更有利于患者髋关节功能的恢复, 手术效果良好。Objective:To investigate the efficacy of biplane double-supported screw fixation in the treatment of femoral neck fractures in the middle-aged and young patients with the assistance of TiRobot.Methods:A retrospective analysis was conducted of the 28 young and middle-aged patients with femoral neck fracture who had been treated by biplane double-supported screw fixation at Department of Traumatic Orthopaedics, Puren Hospital from January 2021 to January 2022. According to the intraoperative use of TiRobot-assistance in the nail placement, they were divided into 2 even groups ( n=14). In the observation group where a TiRobot was used to assist nail placement, there were 6 males and 8 females, with an age of (44.1±8.7) years. In the control group where nail placement was monitored by conventional C-arm fluoroscopy, there were 7 males and 7 females, with an age of (48.8±8.0) years. The 2 groups were compared in terms of operation time, intraoperative fluoroscopy times, intraoperative blood loss, hospitalization time, fracture healing time, postoperative complications and hip function 6 months after operation. Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The operation time, intraoperative fluoroscopy times, intraoperative blood loss and hospitalization time in the observation group were significantly less than those in the control group [(66.5±3.7) min versus (77.1±3.9) min, (12.8±1.6) times versus (18.7±2.5) times, 3.5 (2.8, 4.0) mL versus 26.0 (24.0, 27.3) mL, (9.4±1.2) d versus (11.3±1.2) d] ( P< 0.05). During the follow-up period, the fractures healed well in both groups with no obvious complications. The fracture healing time in the observation group was (6.1±1.2) months, insignificantly shorter than that in the control group [(6.3±1.1) months] ( P>0.5). The Harris hip score 6 months after operation in the observation group (92.6±2.7) was significantly higher than that in the control group (90.6±1.9) ( P< 0.05). Con

关 键 词：股骨颈骨折 骨科机器人 骨折固定术 内 骨钉 双平面双支撑螺钉固定 

分 类 号：R687.3[医药卫生—骨科学]