| 冯延松,朱成明,梁伟,等.机器人导航辅助下股骨颈动力交叉钉系统和空心螺钉治疗不稳定型股骨颈骨折的近期疗效比较.骨科,2025,16(4): 331-336. |
| 机器人导航辅助下股骨颈动力交叉钉系统和空心螺钉治疗不稳定型股骨颈骨折的近期疗效比较 |
| Comparison of short-term efficacy of femoral neck system and cannulated compression screws treatment for unstable femoral neck fractures assisted by robot navigation |
| 投稿时间：2025-02-24 |
| DOI：DOI：10.3969/j.issn.1674-8573.2025.04.008 |
| 中文关键词: 机器人导航 股骨颈骨折 空心螺钉 股骨颈动力交叉钉系统 生物力学 |
| 英文关键词: Robotic navigation Femoral neck fracture Cannulated screws Femoral neck system Biomechanics |
| 基金项目:广西卫健委自筹经费科研课题（Z-B20241486）；柳州市科技计划项目（2024YB0301A001） |
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| 中文摘要: |
| 目的 探讨天玑机器人导航辅助下股骨颈动力交叉钉系统（FNS）与空心螺钉（CCS）治疗中青年不稳定型股骨颈骨折的近期临床疗效。方法 回顾性分析2020年3月至2023年6月于我院创伤中心接受治疗的69例中青年不稳定型股骨颈骨折病人的临床资料，其中男41例，女28例，年龄为（40.9±8.3）岁（18~62岁）。根据Garden分型，Ⅲ型56例，Ⅳ型13例。所有病人均接受天玑机器人导航辅助下的股骨颈骨折闭合复位内固定术，根据内固定方式不同分为两组，FNS组32例，CCS组37例。比较两组病人的手术时间、术中出血量、住院时间、下地负重时间、骨折愈合时间、股骨颈短缩程度、术后并发症发生率、末次随访时的髋关节Harris评分与疼痛视觉模拟量表（visual analogue scale，VAS）评分。结果 FNS组的手术时间长于CCS组［（38.8±5.4） min vs. （33.1±4.9） min］，术中出血量高于CCS组［38（30，45）mL vs. 28（20，35） mL］，差异有统计学意义（P＜0.05）。两组住院时间、下地负重时间的差异无统计学意义（P＞0.05）。FNS组骨折愈合时间［13.0（12.0，14.0）周］短于CCS组［（15.0（14.0，16.0）周，P＜0.05］。末次随访时，FNS组股骨颈短缩程度、Harris评分及VAS评分均优于CCS组（P＜0.05）。两组术后并发症及股骨头缺血性坏死发生率的差异无统计学意义（P＞0.05）。结论 机器人导航辅助下FNS治疗中青年不稳定型股骨颈骨折，在骨折愈合速度、股骨颈短缩控制及术后早期髋关节功能恢复方面有优势，但需进一步扩大样本量研究，验证其长期疗效。 |
| 英文摘要: |
| Objective To compare the short-term clinical outcomes of femoral neck system (FNS) versus cannulated compression screws (CCS) for treating unstable femoral neck fractures in young and middle-aged patients under TiRobot navigation assistance. Methods A retrospective analysis was conducted on 69 patients with unstable femoral neck fractures treated at our trauma center from March 2020 to June 2023, including 41 males and 28 females, aged (40.9±8.3) years (18-62 years). According to Garden classification, there were 56 cases of type Ⅲ and 13 cases of type Ⅳ. All patients underwent TiRobot-assisted closed reduction and internal fixation. They were divided into two groups based on different internal fixation methods: 32 cases in the FNS group and 37 cases in the CCS group. Comparisons included operative time, blood loss, hospitalization duration, time to weight-bearing, fracture healing time, femoral neck shortening, complication rates, and Harris hip score (HHS), visual analogue scale (VAS) scores at last follow-up. Results The operative time in the FNS group was longer than that in the CCS group ［(38.8±5.4) min vs. (33.1±4.9) min］, and the blood loss was higher than that in the CCS group ［38 (30, 45) mL vs. 28 (20, 35) mL］, with statistical significance (P＜0.05). The difference in hospitalization time and time to weight-bearing between the two groups were not statistically significant (P＞0.05). The fracture healing time ［13.0 (12.0, 14.0) weeks］ in the FNS group was shorter than that in the CCS group ［(15.0 (14.0, 16.0) weeks, P＜0.05］. At the last follow-up, FNS group demonstrated superior outcomes in femoral neck shortening, HHS, and VAS scores (P＜0.05), with no significant difference in complications or avascular necrosis rates (P＞0.05). Conclusion Under TiRobot navigation, FNS offers advantages over CCS in accelerating fracture healing, minimizing femoral neck shortening, and improving early hip function for unstable femoral neck fractures in young adults. Larger studies are warranted to validate long-term efficacy. |
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