机器人辅助空心加压螺钉内固定治疗儿童股骨颈骨折:10例病例系列
Robot-assisted cannulated compression screw internal fixation for treatment of femoral neck fracture in children: A case series of ten patients.
作者信息
Feng Wei, Yao Ziming, Liu Haonan, Guo Dong, Zhu Danjiang, Song Baojian, Wang Qiang, Zhang Xuejun
机构信息
Department of Orthopedics, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
出版信息
Front Pediatr. 2023 Jan 9;10:1105717. doi: 10.3389/fped.2022.1105717. eCollection 2022.
PURPOSE
To investigate the safety and efficacy of robot-assisted cannulated compression screw internal fixation in the treatment of femoral neck fracture in children.
METHODS
We retrospectively reviewed the data of ten children with femoral neck fractures treated by robot-assisted internal fixation from January 2020 to June 2021. The clinical and radiological characteristics, operation duration, and fluoroscopy frequency of robot-assisted screws placement together with the complications and function were evaluated. At the 12-month follow-up, the hip joint function was evaluated using the Ratliff classification.
RESULTS
Ten children, six boys and four girls, aged 4-14 years were included. There were eight type II and three type III femoral neck fractures using the Delbet classification. In the process of robot-assisted internal fixation, the median of fluoroscopy frequency was 22 times and the median of operation duration was 47 min. The median of screw parallelism was 1.33° and 0.66° on the anteroposterior and lateral x-ray films, and the median of screw distribution was 41.86% and 44.93% on the anteroposterior and lateral x-ray films, respectively. At the 12-month follow-up, there were two cases of femoral head necrosis, and fracture healing was achieved in all patients, of which eight fractures were excellent and three were good by the Ratliff function classification.
DISCUSSION
The application of robot-assisted cannulated compression screw internal fixation could help us achieve more safe and accurate screw placement, as well as a good treatment effect for children's femoral neck fractures.
LEVEL OF EVIDENCE
Level IV. retrospective case series.
目的
探讨机器人辅助空心加压螺钉内固定治疗儿童股骨颈骨折的安全性和有效性。
方法
回顾性分析2020年1月至2021年6月采用机器人辅助内固定治疗的10例儿童股骨颈骨折患者的数据。评估机器人辅助螺钉置入的临床和影像学特征、手术时间、透视次数以及并发症和功能情况。在12个月随访时,采用Ratliff分类法评估髋关节功能。
结果
纳入10例儿童,年龄4 - 14岁,其中男孩6例,女孩4例。按照Delbet分类,有8例II型和3例III型股骨颈骨折。在机器人辅助内固定过程中,透视次数中位数为22次,手术时间中位数为47分钟。前后位和侧位X线片上螺钉平行度中位数分别为1.33°和0.66°,前后位和侧位X线片上螺钉分布中位数分别为41.86%和44.93%。在12个月随访时,有2例股骨头坏死,所有患者骨折均愈合,根据Ratliff功能分类,其中8例骨折为优,3例为良。
讨论
机器人辅助空心加压螺钉内固定的应用有助于更安全、准确地置入螺钉,对儿童股骨颈骨折也有良好的治疗效果。
证据级别
IV级。回顾性病例系列。