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天玑机器人辅助股骨颈骨折螺钉置入与传统空心螺钉内固定疗效比较

[Comparison of curative effect between Tianji robot assisted screw placement and traditional cannulated screw internal fixation for femoral neck fracture].

作者信息

Nie De-Xin, Sun Wen-Gao, Wang Xiao-Qiang, Wang Ming-Jun, Sun Jin-Bo, Chen Chun

机构信息

Orthopaedic Joints, Sports Medicine, Pediatric Orthopedics, Xingyi Hospital Affiliated to Guizhou Medical University, Xingyi 562400, Guizhou, China.

出版信息

Zhongguo Gu Shang. 2023 Mar 25;36(3):221-5. doi: 10.12200/j.issn.1003-0034.2023.03.005.

Abstract

OBJECTIVE

To investigate the clinical efficacy and advantages of Tianji orthopedic robot assisted cannulated screw internal fixation for femoral neck fracture.

METHODS

The clinical data of 41 patients with femoral neck fracture who underwent internal fixation with cannulated screws from January 2019 to January 2022 were retrospectively analyzed. According to different surgical methods, they were divided into Tianji robot group and traditional cannulated screw fixation group (traditional operation group). Among them, there were 18 patients in Tianji robot group including 8 males and 10 females with age of (56.00±4.22) years old, Garden typeⅠ (4 cases), type Ⅱ (11 cases), type Ⅲ (2 cases), and type Ⅳ (1 case). There were 23 patients in the traditional operation group, including 10 males and 13 females, aged (54.87±4.81) years old;there were 5 cases of Garden typeⅠ, 14 cases of type Ⅱ, 3 cases of type Ⅲ and 1 case of type Ⅳ. The operation time, intraoperative blood loss, fluoroscopy times, guide needle placement times, operation costs and other indicators were observed and compared between two groups. Harris score was used to evaluate hip joint function 12 months after operation.

RESULTS

The wounds of all patients healed in Grade A without complications. There were significant differences between two groups in terms of operation time, times of intraoperative fluoroscopy, times of guide needle placement, amount of intraoperative bleeding, and operation cost (<0.05). All 41 patients were followed up for at least 12 months. The fractures of both groups were healed. There was no infection, screw loosening, fracture displacement and femoral head necrosis in Tianji robot group during follow-up;Screw loosening occurred in 2 patients in the traditional operation group during follow-up. At 12 months after operation, Harris hip joint function score of Tianji robot group was higher than that of traditional operation group in daily activity, lameness, joint activity score and total score (<0.05).

CONCLUSION

Tianji robot assisted nail placement is a better method for the treatment of femoral neck fracture, which improves the surgical efficiency, is more accurate, has higher success rate of one-time nail placement, shorter operation time, less radiation, and has better hip joint function recovery after surgery.

摘要

目的

探讨天玑骨科机器人辅助空心钉内固定治疗股骨颈骨折的临床疗效及优势。

方法

回顾性分析2019年1月至2022年1月期间41例行空心钉内固定治疗的股骨颈骨折患者的临床资料。根据手术方式不同,将其分为天玑机器人组和传统空心钉固定组(传统手术组)。其中,天玑机器人组18例,男8例,女10例,年龄(56.00±4.22)岁,GardenⅠ型4例,Ⅱ型11例,Ⅲ型2例,Ⅳ型1例。传统手术组23例,男10例,女13例,年龄(54.87±4.81)岁;GardenⅠ型5例,Ⅱ型14例,Ⅲ型3例,Ⅳ型1例。观察并比较两组的手术时间、术中出血量、透视次数、导针置入次数、手术费用等指标。采用Harris评分在术后12个月评估髋关节功能。

结果

所有患者伤口均甲级愈合,无并发症发生。两组在手术时间、术中透视次数、导针置入次数、术中出血量及手术费用方面比较,差异有统计学意义(<0.05)。41例患者均至少随访12个月。两组骨折均愈合。随访期间天玑机器人组无感染、螺钉松动、骨折移位及股骨头坏死发生;传统手术组随访期间有2例患者发生螺钉松动。术后12个月,天玑机器人组Harris髋关节功能评分在日常活动、跛行、关节活动评分及总分方面均高于传统手术组(<0.05)。

结论

天玑机器人辅助置钉是治疗股骨颈骨折的较好方法,可提高手术效率,更加精准,一次性置钉成功率高,手术时间短,辐射少,术后髋关节功能恢复较好。

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