| 廖永成,张明,徐俊华,等.骨科手术机器人精准导航辅助空心螺钉内固定治疗中青年股骨颈骨折的疗效分析.骨科,2023,14(5): 428-433. |
| 骨科手术机器人精准导航辅助空心螺钉内固定治疗中青年股骨颈骨折的疗效分析 |
| Therapeutic Effect of Precise Navigation Assisted Cannulated Screw Internal Fixation in the Treatment of Young and Middle-aged Femoral Neck Fracture Based on Orthopaedic Surgery Robot |
| 投稿时间：2023-02-04 |
| DOI：10.3969/j.issn.1674-8573.2023.05.007 |
| 中文关键词: 股骨颈骨折 机器人 空心螺钉 内固定 中青年 随访 |
| 英文关键词: Femoral neck fracture TiRobot Cannulated screw Internal fixation of fracture Middle-aged and young people Follow-up |
| 基金项目:武汉市卫生健康委员会科研项目（WX20B19）；武汉科技大学职业危害识别与控制湖北省重点实验室开放基金项目（OHIC2020Z02） |
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| 中文摘要: |
| 目的 探讨应用骨科手术机器人精准导航辅助空心螺钉内固定治疗中青年股骨颈骨折的疗效及优势。方法 回顾性分析武汉科技大学附属普仁医院2021年1月至2022年6月采用多枚空心螺钉内固定法治疗的30例中青年股骨颈骨折病人。根据术中是否使用机器人辅助置钉分为两组，观察组采用天玑骨科手术机器人辅助置钉，男7例，女8例，年龄为（48.67±7.83）岁；对照组采用传统方法在“C”型臂X线机监视下置钉，男6例，女9例，年龄为（48.60±7.71）岁。记录并比较两组病人的手术时间、术中透视次数、术中失血量、住院时间、骨折愈合时间、术后并发症发生情况和术后6个月Harris评分。结果 本研究共置入90枚空心螺钉，每例病人置入3枚空心螺钉。病人均获得随访，随访时间为6~12个月，平均8.7个月。观察组病人手术时间、术中透视次数、术中失血量、住院时间均显著优于对照组［（56.93±5.65） min vs. （69.87±3.96） min，（12.73±1.28）次 vs. （18.87±2.47）次，（12.60±1.80） mL vs. （25.53±2.39） mL，（8.67±1.18） d vs. （10.87±1.19） d］，差异有统计学意义（P＜0.05）。随访期间两组病人髋部疼痛明显缓解，骨折均愈合良好，无明显并发症发生，观察组病人骨折愈合时间优于对照组，但差异无统计学意义（P＞0.05）。术后6个月观察组髋关节Harris评分显著高于对照组，差异有统计学意义（P＜0.05）。结论 与传统“C”型臂X线机监视下置钉相比，骨科手术机器人辅助空心螺钉内固定治疗中青年股骨颈骨折，可以显著缩短病人的手术时间和住院时间，减少病人术中透视次数和术中失血量，更有利于病人髋关节功能的恢复，临床效果满意。 |
| 英文摘要: |
| Objective To explore the efficacy and advantages of precision navigation assisted cannulated screws internal fixation with orthopedic surgery robot in the treatment of femoral neck fracture in middle-aged and young people. Methods From January 2021 to June 2022, 30 young and middle-aged patients with femoral neck fracture treated with multiple cannulated screws in Puren Hospital, Wuhan University of Science and Technology were analyzed retrospectively. According to the use of robot-assisted screw placement during the operation, the patients were divided into two groups. The observation group was assisted by TiRobot, including 7 males and 8 females, with an age of (48.67±7.83) years. In the control group, screws were placed under the monitoring of “C” arm X-ray machine, including 6 males and 9 females, with an age of (48.60±7.71) years. The operation time, intraoperative fluoroscopy times, intraoperative blood loss, hospitalization time, fracture healing time, postoperative complications and Harris score at 6th month after operation were recorded and compared between the two groups. Results A total of 90 cannulated screws were implanted in this study, and 3 cannulated screws were placed in each patient. All patients were followed up for 6 to 12 months (mean 8.7 months). The operation time, intraoperative fluoroscopy times, intraoperative blood loss and hospitalization time in the observation group were significantly better than those in the control group ［(56.93±5.65) min vs. (69.87±3.96) min, (12.73±1.28) times vs. (18.87±2.47) times, (12.60±1.80) mL vs. (25.53±2.39) mL, (8.67±1.18) d vs. (10.87±1.19) d, P＜0.05］. During the follow-up period, the hip pain was significantly relieved, the fractures healed well, and no obvious complications occurred in the two groups. The fracture healing time in the observation group was shorter than that in the control group, but the difference was not statistically significant (P＞0.05). At 6th month after operation, the hip joint Harris score in the observation group was significantly higher than that in the control group (P＜0.05). Conclusion Compared with the screws placed under the supervision of the traditional “C” arm X-ray machine, orthopedic surgery robot assisted cannulated screws internal fixation in the treatment of young and middle-aged femoral neck fractures can significantly shorten the operation time and hospitalization time of the patients, reduce the times of intraoperative fluoroscopy and intraoperative blood loss, more conducive to the recovery of hip joint function of patients, and the clinical effect is satisfactory. |
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