Department of Orthopaedics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32# W. Sec 2, 1st Ring Rd, Qingyang District, Chengdu, 610072, China.
Int Orthop. 2023 Jun;47(6):1601-1608. doi: 10.1007/s00264-023-05794-x. Epub 2023 Mar 30.
To compare the merits and demerits of percutaneous robot-assisted screw fixation for nondisplaced pelvic fractures with other treatments via long-term follow-up.
This was a retrospective analysis of nondisplaced pelvic fractures treated between January 2015 and December 2021. The number of fluoroscopy exposures, operative duration, intraoperative blood loss, surgical complications, screw placement accuracy and Majeed score were compared among the nonoperative group (24 cases), open reduction and internal fixation (ORIF) group (45 cases), free-hand empirical screw fixation (FH) group (10 cases) and robot-assisted screw fixation (RA) group (40 cases).
There was less intraoperative blood loss in the RA and FH groups than in the ORIF group. The number of fluoroscopy exposures in the RA group was lower than that in the FH group but much higher than that in the ORIF group. There were five cases of wound infection in the ORIF group and no surgical complications in the FH or RA group. The medical expenses were higher in the RA group than in the FH group, with no significant difference from the ORIF group. The Majeed score was lowest in the nonoperative group three months after injury (64.5±12.0) but lowest in the ORIF group one year after injury (88.6±4.1).
Percutaneous RA for nondisplaced pelvic fractures is effective and minimally invasive and does not increase medical expenses compared with ORIF. Therefore, it is the best choice for patients with nondisplaced pelvic fractures.
通过长期随访，比较经皮机器人辅助螺钉固定治疗无移位骨盆骨折与其他治疗方法的优缺点。
这是一项回顾性分析，纳入 2015 年 1 月至 2021 年 12 月期间治疗的无移位骨盆骨折患者。比较非手术组（24 例）、切开复位内固定（ORIF）组（45 例）、徒手经验性螺钉固定（FH）组（10 例）和机器人辅助螺钉固定（RA）组（40 例）的透视曝光次数、手术时间、术中出血量、手术并发症、螺钉放置准确性和 Majeed 评分。
RA 和 FH 组的术中出血量均少于 ORIF 组。RA 组的透视曝光次数低于 FH 组，但明显高于 ORIF 组。ORIF 组有 5 例伤口感染，FH 或 RA 组无手术并发症。RA 组的医疗费用高于 FH 组，但与 ORIF 组无显著差异。受伤后 3 个月，非手术组的 Majeed 评分最低（64.5±12.0），受伤后 1 年，ORIF 组的 Majeed 评分最低（88.6±4.1）。
与 ORIF 相比，经皮机器人辅助螺钉固定治疗无移位骨盆骨折具有微创、疗效确切的优点，不会增加医疗费用。因此，对于无移位骨盆骨折患者，机器人辅助螺钉固定是最佳选择。
