机器人辅助经皮空心钉内固定治疗Tilt骨盆骨折的疗效  

Robot-assisted Percutaneous Cannulated Screw Fixation for Tilt Pelvic Fractures

作　　者：罗俊浩 马运宏 李泽清 吴永伟 芮永军 Luo Junhao;Ma Yunhong;Li Zeqing(Department of Traumatic Orthopedics,Wuxi Ninth People’s Hospital Affiliated to Soochow University,Wuxi 214062,China)

机构地区：[1]苏州大学附属无锡市第九人民医院创伤骨科,无锡214062

出　　处：《中国微创外科杂志》2025年第1期21-26,共6页Chinese Journal of Minimally Invasive Surgery

基　　金：无锡市“太湖人才计划”顶尖医学团队课题资助(TTPJY202101)。

摘　　要：目的探讨骨科机器人辅助经皮空心钉内固定治疗Tilt骨盆骨折的疗效。方法回顾性分析2020年1月~2023年10月“天玑”骨科手术机器人联合三维C臂辅助经皮空心钉内固定治疗21例Tilt骨盆骨折的临床资料。Tile分型B2.1型11例,B2.2型3例,B2.3型2例,B3型5例。结果21例均安全经皮置入空心螺钉,共置入71枚螺钉,其中S1螺钉21枚,S2螺钉21枚,耻骨支螺钉21枚(顺行螺钉14枚,逆行螺钉7枚),LC-Ⅱ螺钉4枚,改良LC-Ⅱ螺钉4枚。单枚螺钉置入时间(31.1±10.8)min,单枚螺钉透视时间(5.9±1.7)min,每例患者手术时间(100.7±16.2)min,出血量(11.2±4.2)ml。骨折复位质量(Matta标准)优8例,良11例,可2例,优良率90.5%(19/21)。螺钉置入质量(Gras分类)优65枚,良6枚,优良率100%(71/71)。21例随访4~18(10.7±8.4)月。均达到骨性愈合,骨折愈合时间(12.7±1.8)周。末次随访时骨盆功能(Majeed评分系统)优7例,良11例,可3例,优良率85.7%(18/21)。2例股外侧皮神经损伤,2例肌间静脉血栓,均治愈。结论使用骨科机器人辅助经皮空心钉内固定治疗Tilt骨盆骨折,螺钉置入准确,无需调整,可获得满意疗效。Objective To explore the therapeutic effect of orthopedic robot assisted percutaneous cannulated screw internal fixation in the treatment of Tilt pelvic fractures.Methods A retrospective analysis was made on clinical data of 21 cases of Tilt pelvic fractures treated with“Tianji”orthopedic surgical robot combined with 3D C-arm fluoroscopy assisted percutaneous cannulated screw internal fixation from January 2020 to October 2023.The Tile classification included 11 cases of type B2.1,3 cases of type B2.2,2 cases of type B2.3,and 5 cases of type B3.Results The percutaneous insertion of cannulated screw was safe in all the 21 cases,with a total of 71 screws inserted,including 21 S1 screws,21 S2 screws,21 pubic branch screws(14 anterograde screws and 7 retrograde screws),4 LC-Ⅱscrews,and 4 modified LC-Ⅱscrews.The insertion time of a single screw was(31.1±10.8)min,the fluoroscopy time of a single screw was(5.9±1.7)min,the surgical time was(100.7±16.2)min,and the bleeding volume was(11.2±4.2)ml.According to the Matta criteria,8 cases had excellent fracture reduction quality,11 cases were good,and 2 cases were fair,with an excellent and good rate of 90.5%(19/21).According to the Gras classification,the quality of screw placement was excellent in 65 cases and good in 6 cases,with an excellent and good rate of 100%(71/71).The 21 cases were followed up for 4-18(mean,10.7±8.4)months.The bone healing was achieved in all the cases,with a fracture healing time of(12.7±1.8)weeks.At the last follow-up,according to the Majeed scoring system,7 cases were rated as excellent pelvic function,11 cases as good,and 3 cases as fair,with an excellent and good rate of 85.7%(18/21).Two cases of lateral femoral cutaneous nerve injury and two cases of intermuscular vein thrombosis were cured.Conclusion The use of orthopedic robot assisted percutaneous cannulated screw fixation for the treatment of Tilt pelvic fractures has satisfactory therapeutic effects,with accurate screw placement and no need for adjustment.

关 键 词：Tilt骨盆骨折 手术机器人 微创手术 通道螺钉 

分 类 号：R68[医药卫生—骨科学]