C型臂透视与骨科手术机器人三维成像系统在股骨颈骨折闭合复位内固定术中的应用对比  

A comparative study of C-arm fluoroscopy and 3D imaging system of orthopedic surgery robot in closed reduction and internal fixation for femoral neck fracture

作　　者：庞益群 吴亚玲 李蒙 李磊[2] PANG Yiqun;WU Yaling;LI Meng;LI Lei(Department of Radiology,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China;Department of Orthopedics,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院影像科,安徽合肥230001 [2]中国科学技术大学附属第一医院创伤骨科,安徽合肥230001

出　　处：《西部医学》2023年第4期533-537,542,共6页Medical Journal of West China

基　　金：中央高校基本科研业务费专项资金资助(WK9110000178);医学人工智能联合基金项目(MAI2022Q01)。

摘　　要：目的 探讨C型臂透视与骨科手术机器人三维成像系统在股骨颈骨折闭合复位内固定术中的应用比较。方法 收集2021年6月—2021年12月我院45例闭合复位空心钉内固定治疗股骨颈骨折患者的病历资料,包括C型臂透视辅助内固定患者25例(C型臂透视组)及骨科手术机器人三维成像系统辅助内固定患者20例(三维成像组)。分别记录患者性别、年龄、骨折Pauwels分型、受伤至手术时间、手术时间、术中出血量、导针置入次数、术中透续时间、透视次数、后上方螺钉穿出例数、末次随访时疼痛VAS评分、髋关节功能Harris评分及骨折愈合情况等并对两组进行比较。结果 与三维成像组比较,C型臂透视组导针置入次数多、透视时间长、透视次数多、末次随访VAS评分高,后上方螺钉穿出发生率高,而三维成像组手术时间、患者透视次数大于C型臂透视组(P<0.05)。两组术中出血量、髋关节功能比较差异无统计学意义(P>0.05)。两组末次随访时均骨性愈合,无术后并发症。结论 三维成像辅助股骨颈骨折闭合复位内固定置钉精确性高,患者术后疼痛轻,医师接触射线减少,但手术时间较长,且相较于C型臂透视辅助可能使患者吸收更多的X线辐射,应重视对患者的防护。Objective To explore the differences of C-arm fluoroscopy and 3D imaging system of orthopedic surgery robot in closed reduction and internal fixation for femoral neck fracture.Methods From June 2021 to December 2021,medical records of 45 patients with femoral neck fracture treated with closed reduction and cannulated screws internal fixation were collected,including 25 patients with C-arm fluoroscopic-assisted internal fixation and 20 patients with orthopedic surgery robot 3D imaging system-assisted internal fixation.Gender,age,fracture Pauwels classification,time from injury to operation,operation time,intraoperative blood loss,guide pins drilling times,intraoperative duration of fluoroscopy(patients and doctors),number of fluoroscopy(patients and doctors),number of in-out-in of posterior screws,VAS score,Harris scores and fracture healing or not were compared between the two groups.Results In the C-arm fluoroscopy group,there were more times of guide pins implantation,longer time of doctors and patients fluoroscopy,more times of doctor fluoroscopy,higher VAS score at the last follow-up,and higher incidence of in-out in posterior and upper screw,while no screws in-out-in,the longer operation time and more fluoroscopy of patients were observed in the 3D imaging group.There was no difference in intraoperative blood loss and hip function between the two groups,and bone healing was observed at the last follow-up without postoperative complications.Conclusion The 3D imaging-assisted screws placement for closed reduction and internal fixation of femoral neck fracture has high accuracy,light postoperative pain and greatly reduced exposure to radiation,but there is a certain learning curve and longer operation time.In addition,compared with c-arm fluoroscopy,patients may absorb more X-ray radiation and attention should be paid.

关 键 词：骨科手术机器人 三维成像 股骨颈骨折 内固定 

分 类 号：R687.3[医药卫生—骨科学]