机器人导航辅助置钉在空心螺钉固定治疗肩胛骨喙突骨折中的应用  

Screw placement assisted by robotic navigation in cannulated screw fixation for fracture of scapular coracoid process

作　　者：王晨[1] 潘虎 费晨 蒋武强 雷磊[1] 许帆 叶爱明 王展[1] 张堃[1] 宋哲[1] 樊伟[1] Wang Chen;Pan Hu;Fei Chen;Jiang Wuqiang;Lei Lei;Xu Fan;Ye Aiming;Wang Zhan;Zhang Kun;Song Zhe;Fan Wei(Department of Orthopaedics and Trauma,Red Cross Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710054,China;Department of Orthopaedics,Gaoling District Hospital,Xi'an 710200,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 [2]西安市高陵区医院骨一科,西安710200

出　　处：《中华创伤骨科杂志》2024年第9期804-809,共6页Chinese Journal of Orthopaedic Trauma

基　　金：陕西重点研发项目(2023-YBSF-167)。

摘　　要：目的探讨机器人导航辅助置钉在空心螺钉固定治疗肩胛骨喙突骨折中的应用效果。方法回顾性分析2020年1月至2023年12月期间西安交通大学附属红会医院创伤骨科采用空心螺钉固定治疗的24例肩胛骨喙突骨折患者资料。根据术中是否应用机器人导航辅助置钉分为两组:A组11例,男6例,女5例;年龄(47.4±3.4)岁;术中应用机器人导航辅助置钉。B组13例,男10例,女3例;年龄(43.5±4.9)岁;术中应用传统C型臂X线机透视置钉。比较两组患者的手术时间、术中出血量、术中透视次数、术中导针调整次数、骨折愈合时间、末次随访时肩关节功能Constant-Murley评分及随访期间并发症发生情况等。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。A组和B组患者的随访时间分别为(25.3±9.1)、(27.6±10.8)个月,差异无统计学意义(P>0.05)。A组患者的术中出血量[(51.8±35.7)mL]、术中透视次数[(5.7±1.0)次]及术中导针调整次数[(1.6±0.7)次]均显著少于B组患者[(123.8±73.9)mL、(12.5±2.7)次、(5.3±1.0)次],差异均有统计学意义(P<0.05)。A组和B组患者的手术时间[(88.2±21.3)、(80.4±31.1)min]、骨折愈合时间[(10.0±1.3)、(11.5±2.7)周]及末次随访时肩关节功能Constant-Murley评分[(86.7±6.1)、(91.1±10.0)分]比较差异均无统计学意义(P>0.05)。随访期间无一例患者发生伤口感染、骨折不愈合及内固定失效等并发症。结论空心螺钉固定治疗肩胛骨喙突骨折术中应用机器人导航辅助置钉可以取得与传统置钉方法相当的良好疗效,且能减少术中出血量和X线辐射,提高手术精确度。Objective To evaluate the screw placement assisted by robotic navigation in cannulated screw fixation for treatment of fracture of scapular coracoid process.Methods A retrospective study was conducted to analyze the data of 24 patients with fracture of scapular coracoid process who had been treated by cannulated screw fixation at Department of Orthopaedics and Trauma, Red Cross Hospital Affiliated to Xi'an Jiaotong University from January 2020 to December 2023. According to whether the intraoperative screw placement was assisted by robotic navigation or not, the patients were divided into 2 groups. In group A of 11 cases, there were 6 males and 5 females with an age of (47.4±3.4) years whose screw placement was assisted by robotic navigation during the internal fixation with cannulated screws. In group B of 13 cases, there were 10 males and 3 females with an age of (43.5±4.9) years whose screw placement was assisted by conventional C-arm X-ray fluoroscopy during the internal fixation with cannulated screws. The operative time, intraoperative blood loss, fracture healing time, intraoperative fluoroscopy frequency, intraoperative adjustments of guide wire, Constant-Murley score of shoulder function at the last follow-up and postoperative complications were compared between the 2 groups.Results There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The follow-up time was (25.3±9.1) months for group A and (27.6±10.8) months for group B, showing no statistically significant difference ( P>0.05). The intraoperative blood loss [(51.8±35.7) mL], intraoperative fluoroscopy frequency [(5.7±1.0) times] and intraoperative adjustments of guide wire [(1.6±0.7) times] in group A were significantly less than those in group B [(123.8±73.9) mL, (12.5±2.7) times, and (5.3±1.0) times] ( P<0.05). There were no significant differences in operative time [(88.2±21.3) min versus (80.4±31.1) min], fracture healing time [(10.0±1.3) weeks versus (11.5±2.7)

关 键 词：机器人 肩胛骨 喙突骨折 骨折固定术 内 骨钉 

分 类 号：R687.3[医药卫生—骨科学]