Wang Cheng, Fu Shaoling, Li Xueqian, Wang Jiazheng, Wu Chenglin, Zhang Jieyuan, Song Guoxun, Gu Wenqi, Shi Zhongmin
Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai, China.
Front Surg. 2023 Jan 5;9:1049455. doi: 10.3389/fsurg.2022.1049455. eCollection 2022.
Long recovery time, large scar, postoperative swelling and pain are possible side effects of open reduction internal fixation (ORIF) for tarsal navicular fractures. Early exercise instruction is made possible by the use of an intraoperative robot-assisted percutaneous invasive closed reduction internal fixation. The goal of the trial was to determine whether percutaneous screw internal fixation with robot assistance might be used to treat navicular fractures.
27 patients with navicular fractures had surgical treatment between June 2019 and December 2021. Of those, 20 instances were treated with ORIF, while 7 cases had robot-assisted percutaneous screw internal fixation. At the final follow-up, the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score and the visual analogue scale (VAS) score were compared to determine outcomes and function.
Follow-up was obtained in all 27 patients after surgery, with a mean follow-up time of 21.81 months, ranging from 15 to 29 months . In the 7 instances of robot-assisted group, percutaneous guide wire insertion and screw placement only needed one attempt and the depth and position of the implant were both satisfactory. In the ORIF group, there were two patients who sustained cutaneous nerve injuries. The AOFAS score and the VAS score of the group receiving robot-assisted navigation percutaneous screw fixation were 92.25 ± 2.22 and 0.75 ± 0.25 respectively at the last follow-up, while 82.25 ± 7.15 and 0.50 ± 0.29 were the respective values for the ORIF group.
Intraoperative robot-assisted percutaneous closed reduction internal fixation for tarsal navicular fractures can accomplish exact localization of fracture site, reduce soft tissue damage and operative time. According to current view, this method offers fewer complications, a faster recovery after surgery, and more patient satisfaction.
跗舟骨骨折切开复位内固定术（ORIF）可能存在恢复时间长、瘢痕大、术后肿胀和疼痛等副作用。术中使用机器人辅助经皮侵入性闭合复位内固定术使得早期运动指导成为可能。该试验的目的是确定机器人辅助下经皮螺钉内固定术是否可用于治疗舟骨骨折。
2019年6月至2021年12月期间，27例舟骨骨折患者接受了手术治疗。其中，20例采用ORIF治疗，7例采用机器人辅助经皮螺钉内固定术。在末次随访时，比较美国矫形足踝协会（AOFAS）后足评分和视觉模拟量表（VAS）评分，以确定治疗效果和功能。
所有27例患者术后均获得随访，平均随访时间为21.81个月，范围为15至29个月。在机器人辅助组的7例患者中，经皮导丝插入和螺钉置入仅需一次尝试，植入物的深度和位置均令人满意。在ORIF组中，有2例患者发生皮神经损伤。末次随访时，接受机器人辅助导航经皮螺钉固定组的AOFAS评分和VAS评分分别为92.25±2.22和0.75±0.25，而ORIF组的相应值分别为82.25±7.15和0.50±0.29。
术中机器人辅助经皮闭合复位内固定术治疗跗舟骨骨折可实现骨折部位的精确定位，减少软组织损伤和手术时间。根据目前的观点，该方法并发症较少，术后恢复较快，患者满意度较高。
