自研T型架闭合复位结合机器人导航治疗Gartland Ⅲ型儿童肱骨髁上骨折的疗效分析  

Closed reduction with a self-developed T-frame plus robotic navigation to treat supracondylar humeral fractures of Gartland typeⅢin children

作　　者：汤池 白哲 齐昵男 岳思彤 李野 高泽锋 牛成林 张中礼[4] Tang Chi;Bai Zhe;Qi Ninan;Yue Sitong;Li Ye;Gao Zefeng;Niu Chenglin;Zhang Zhongli(Orthopedic Department 3,The Fifth Hospital of Harbin,Harbin 150040,China;Orthopedic Department 11,The Fifth Hospital of Harbin,Harbin 150040,China;Department of Science and Education,The Fifth Hospital of Harbin,Harbin 150040,China;Department of Pediatric Orthopedics,Tianjin Hospital,Tianjin 300202,China)

机构地区：[1]哈尔滨市第五医院骨三科,哈尔滨150040 [2]哈尔滨市第五医院骨十一科,哈尔滨150040 [3]哈尔滨市第五医院科教科,哈尔滨150040 [4]天津医院小儿骨科,天津300202

出　　处：《中华创伤骨科杂志》2024年第11期985-990,共6页Chinese Journal of Orthopaedic Trauma

基　　金：黑龙江省卫生健康委科研项目(20220404070656)。

摘　　要：目的探讨自研T型架闭合复位结合机器人导航精准固定儿童肱骨髁上骨折的疗效。方法回顾性分析2023年1月至2024年3月间在哈尔滨市第五医院接受手术治疗的67例GartlandⅢ型儿童肱骨髁上骨折患者资料。男35例,女32例;年龄(5.6±1.2)岁。所有患儿根据手术方式不同分为2组:对照组(使用闭合复位经皮克氏针内固定治疗)33例和研究组(使用自研T型架复位结合机器人导航进行经皮克氏针内固定治疗)34例。比较两组患儿手术时间、骨折解剖复位率、术中透视次数、术中穿针调整次数、末次随访时Flynn评分及并发症的发生率。结果两组患儿术前一般资料比较差异无统计学意义(P>0.05),具有可比性。所有患儿术后获(6.3±2.5)个月随访。研究组患儿的手术时间、末次随访时Flynn评分及并发症的发生率与对照组比较差异均无统计学意义(P>0.05)。研究组骨折解剖复位率(97.1%,33/34)显著高于对照组(54.5%,18/33),术中透视次数[(28.7±3.9)次]、穿针调整次数[(5.6±1.2)次]均显著低于对照组的(37.2±2.1)、(11.6±2.5)次,差异均有统计学意义(P<0.05)。结论自研T型架对儿童难复性GartlandⅢ型肱骨髁上骨折能够起到很好的复位并临时固定的作用,可使术中使用机器人导航穿针固定时避免反复多次复位、调整穿针造成的医源性副损伤。ObjectiveTo study the efficacy of closed reduction with a self-developed T-frame plus robotic navigation in the treatment of supracondylar humeral fractures of Gartland typeⅢin children.MethodsA retrospective study was conducted to analyze the data of 67 children with supracondylar fracture of Gartland typeⅢwho had undergone surgery at The Fifth Hospital of Harbin from January 2023 to March 2024.There were 35 males and 32 females with an age of(5.6±1.2)years.The children were divided into 2 groups according to different surgical methods.The control group(33 cases)was treated by closed reduction and internal fixation with percutaneous K-wire and the study group(34 cases)by closed reduction with a self-developed T-frame plus robotic navigation for internal fixation with percutaneous K-wire.The operation time,anatomical reduction,intraoperative fluoroscopy frequency,intraoperative needle adjustment,Flynn score at the last follow-up and complications were compared between the 2 groups.ResultsThere was no significant difference in the preoperative general data between the 2 groups,indicating comparability(P>0.05).All children were followed up for(6.3±2.5)months after surgery.There were no significant differences in operation time,Flynn score at the last follow-up or incidence of complications between the study and the control groups(P>0.05).The rate of anatomical reduction in the study group(97.1%,33/34)was significantly higher than that in the control group(54.5%,18/33),and the intraoperative fluoroscopy frequency[(11.6±2.5)times]and needle adjustment(5.6±1.2)times in the study group were significantly lower than those in the control group[(37.2±2.1)times and(28.7±3.9)times](P<0.05).ConclusionsIn the treatment of supracondylar humeral fractures of Gartland typeⅢin children,our self-developed T-frame can play a good role in fracture reduction and temporary fixation,avoiding iatrogenic secondary injuries caused by freguent reduction and adjustment of needle threading in the course of robotic navigation.

关 键 词：儿童 外科手术 计算机辅助 机器人 肱骨髁上骨折 

分 类 号：R726.8[医药卫生—儿科]