复位机器人联合导航机器人辅助微创治疗Tile B型骨盆骨折疗效分析  

Effectiveness of reduction robot combined with navigation robot-assisted minimally invasive treatment for Tile type B pelvic fractures

作　　者：廖江波 代永鸿 吴征杰[2] 曾焰辉[2] 李灿辉[2] 王学霖 王军强[3] 赵春鹏[3] 吴新宝[3] LIAO Jiangbo;DAI Yonghong;WU Zhengjie;ZENG Yanhui;LI Canhui;WANG Xuelin;WANG Junqiang;ZHAO Chunpeng;WU Xinbao(The Eighth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine,Foshan Guangdong,528000,P.R.China;The Seventh Department of Orthopedics,Foshan Hospital of Traditional Chinese Medicine,Foshan Guangdong,528000,P.R.China;Department of Orthopedics,Beijing Jishuitan Hospital,Beijing,102208,P.R.China)

机构地区：[1]广州中医药大学第八临床医学院,广东佛山528000 [2]佛山市中医院骨七科,广东佛山528000 [3]北京积水潭医院骨科,北京102208

出　　处：《中国修复重建外科杂志》2024年第8期954-960,共7页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家重点研发计划资助项目(2022YFC2407500)。

摘　　要：目的探讨复位机器人联合导航机器人辅助微创治疗Tile B型骨盆骨折的临床疗效。方法回顾性分析2022年1月—2023年2月10例Tile B型骨盆骨折患者临床资料。男6例,女4例;年龄30~71岁,平均45.5岁。致伤原因:交通事故伤5例,重物压伤3例,高处坠落伤2例。受伤至手术时间4~13 d,平均6.8 d。骨折Tile分型:B1型2例,B2型1例,B3型7例。术中复位机器人辅助闭合复位后,在导航机器人辅助下用经皮螺钉联合或不联合内置外固定架固定前环,骶髂关节螺钉固定后环。记录复位机器人辅助骨折复位时间,并参照Matta评分标准评价复位质量。同时记录手术时间、术中透视次数及时间、术中出血量及并发症发生情况;随访期间骨盆X线片复查骨折愈合情况,Majeed评分评价髋关节功能。结果10例患者骨盆复位时间42~62 min,平均52.3 min;复位质量根据Matta评分标准,获优4例、良5例、中1例,复位优良率为90%。手术时间180~235 min,平均215.5 min;术中透视18~66次,平均31.8次;术中透视时间16~59 s,平均28.6 s;术中出血量50~200 mL,平均110.0 mL;术中均无重要血管、神经损伤发生。术后患者均获随访,随访时间13~18个月,平均16个月。X线片复查示骨折均愈合,愈合时间11~14周,平均12.3周;随访期间1例髋关节周围异位骨化形成。末次随访时,髋关节功能Majeed评分达70~92分,平均72.7分;获优2例、良8例,优良率100%。结论复位机器人联合导航机器人辅助微创治疗Tile B型骨盆骨折具有智能化、安全性高、操作便捷、微创的特点,可获得可靠疗效。Objective To explore the effectiveness of reduction robot combined with navigation robot-assisted minimally invasive treatment for Tile type B pelvic fractures.Methods Between January 2022 and February 2023,10 patients with Tile type B pelvic fractures were admitted.There were 6 males and 4 females with an average age of 45.5 years(range,30-71 years).The fractures were caused by traffic accident in 5 cases,bruising by heavy object in 3 cases,and falling from height in 2 cases.The interval between injury and operation ranged from 4-13 days(mean,6.8 days).There were 2 cases of Tile type B1 fractures,1 case of Tile type B2 fracture,and 7 cases of Tile type B3 fractures.After closed reduction under assistance of reduction robot,the anterior ring was fixed with percutaneous screws with or without internal fixator,and the posterior ring was fixed with sacroiliac joint screws under assistance of navigation robot.The time of fracture reduction assisted by the reduction robot was recorded and the quality of fracture reduction was evaluated according to the Matta scoring criteria.The operation time,intraoperative fluoroscopy frequency and time,intraoperative bleeding volume,and incidence of complications were also recorded.During follow-up,the X-ray film of pelvis was taken to review the fracture healing,and the Majeed score was used to evaluate hip joint function.Results The time of fracture reduction was 42-62 minutes(mean,52.3 minutes).The quality of fracture reduction according to the Matta scoring criteria was rated as excellent in 4 cases,good in 5 cases,and poor in 1 case,with excellent and good rate of 90%.The operation time was 180-235 minutes(mean,215.5 minutes).Intraoperative fluoroscopy was performed 18-66 times(mean,31.8 times).Intraoperative fluoroscopy time was 16-59 seconds(mean,28.6 seconds).The intraoperative bleeding volume was 50-200 mL(range,110.0 mL).No significant vascular or nerve injury occurred during operation.All patients were followed up 13-18 months(mean,16 months).X-ray films showed that all

关 键 词：骨盆骨折 机器人手术 闭合复位 内固定 

分 类 号：R687.3[医药卫生—骨科学]