智能化骨折复位机器人系统辅助治疗新鲜股骨转子下骨折的疗效分析  

Intelligent robot-assisted minimally invasive reduction system for fresh subtrochanteric fractures of the femur

作　　者：马若飞 赵春鹏 肖鸿鹄 卑明健 朱罡 王豫[3,4] 宋迎春 吴新宝 Ma Ruofei;Zhao Chunpeng;Xiao Honghu;Bei Mingjian;Zhu Gang;Wang Yu;Song Yingchun;Wu Xinbao(Department of Orthopaedic Trauma,Beijing Jishuitan Hospital,The Seventh School of Clinical Medicine,Capital Medical University,Beijing 100035,China;Rossum Robot Co.,Ltd,Beijing 100083,China;School of Biological Science and Medical Engineering,Beihang University,Beijing 100083,China;Beijing Advanced Innovation Center for Biomedical Engineering,Beijing 100083,China)

机构地区：[1]首都医科大学附属北京积水潭医院创伤骨科,北京100035 [2]北京罗森博特科技有限公司,北京100083 [3]北京航空航天大学生物与医学工程学院,北京100083 [4]北京市生物医学工程高精尖创新中心,北京100083

出　　处：《中华创伤骨科杂志》2025年第2期109-116,共8页Chinese Journal of Orthopaedic Trauma

基　　金：北京市科技计划项目(Z201100005420033);北京市自然科学基金(19L2011);北京市自然科学基金-海淀原始创新联合基金(L222136);国家重点研发计划(2022YFC2504304)。

摘　　要：目的探究智能化骨折复位机器人系统辅助微创复位新鲜股骨转子下骨折的可行性及有效性。方法回顾性分析2024年1月年至2024年7月期间北京积水潭医院创伤骨科收治的10例新鲜股骨转子下骨折患者资料。男7例,女3例;年龄(45.0±14.3)岁;受伤至手术时间为(7.9±3.7)d。所有患者股骨转子下骨折使用智能化骨折复位机器人系统辅助复位及髓内钉固定治疗。记录患者手术时间、术中复位时长、术中失血量、术中透视次数,通过计算术前规划结果与术后CT重建结果差值,即股骨干长度差值与旋转角度差值来评估复位效果,并用Harris髋关节功能评分评价髋关节功能。结果患者的手术时间为200.0(161.3,217.5)min,术中复位时长为(83.0±35.5)min,术中失血量为(290.0±110.1)mL,术中透视次数为18.5(9.0,19.3)次。所有患者股骨干长度差值为(2.4±1.4)mm,旋转角度差值为5.1°±3.0°。所有患者术后随访(8.2±2.0)个月,末次随访时骨折均愈合,Harris髋关节功能评分为(83.3±4.1)分。结论智能化骨折复位机器人系统可在股骨转子下骨折术前完成自主复位路径规划,并辅助骨折复位,手术效果佳,对新鲜股骨转子下骨折的治疗具有较强的可行性及有效性。ObjectiveTo evaluate the feasibility and efficacy of our self-designed intelligent robot-assisted reduction system for fresh subtrochanteric fractures of the femur.MethodsA retrospective cohort study was conducted to include 10 patients with fresh subtrochanteric fracture of the femur who had been admitted to Department of Orthopedic Trauma,Beijing Jishuitan Hospital from January 2024 to July 2024.There were 7 males and 3 females with an age of(45.0±14.3)years and an interval from injury to surgery of(7.9±3.7)d.All the patients were treated by minimally invasive reduction which was assisted by our self-designed intelligent robot,and internal fixation with intramedullary nails.The operation duration,intraoperative reduction duration,intraoperative blood loss,and intraoperative fluoroscopy frequency were recorded.The reduction effect was evaluated by calculating the differences between preoperative planning and postoperative CT reconstruction(i.e.,the differences in femoral shaft length and in rotation angle).The hip functional recovery was assessed by Harris hip function Scoring.ResultsThe mean operation time was 200.0(161.3,217.5)min,the reduction time(83.0±35.5)min,the intraoperative blood loss(290.0±110.1)mL,and the intraoperative fluoroscopy 18.5(9.0,19.3)times.In all patients,the difference in femoral shaft length was(2.4±1.4)mm,and the difference in rotation angle 5.1°±3.0°.All patients were followed up for(8.2±2.0)months.All the fractures got united at the last follow-up.Their Harris hip function score was(83.3±4.1)points.ConclusionOur self-designed intelligent robot-assisted reduction system is feasible and effective in the surgery of fresh subtrochanteric fracture of the femur,because the robot system can complete the autonomous planning of reduction approaches before surgery and assist fracture reduction under real-time monitoring with three-dimensional images,leading to fine outcomes.

关 键 词：髋关节 机器人 外科手术 微创性 股骨转子下骨折 骨折复位 

分 类 号：R68[医药卫生—骨科学]