Ren French Jonathan Ming, Filer Joshua, Hogan Kathryn, Fletcher James William Alexander, Mitchell Stephen
Limb Reconstruction Unit, Trauma and Orthopaedics, Bristol Royal Infirmary; Musculoskeletal Research Unit, University of Bristol, Bristol, England, United Kingdom.
Limb Reconstruction Unit, Trauma and Orthopaedics, Bristol Royal Infirmary, Bristol, England, United Kingdom.
Strategies Trauma Limb Reconstr. 2024 Jan-Apr;19(1):9-14. doi: 10.5005/jp-journals-10080-1608.
Computerised hexapod-assisted orthopaedic surgery (CHAOS) is a method by which complex multiplanar, multilevel deformity can be corrected with a high degree of accuracy utilising minimally invasive techniques within a single operative event. This study's aim was to report the reliability, accuracy and magnitude of correction achieved, alongside patient-reported outcomes and risk factors for complications when using the CHAOS technique throughout the lower limb.
Retrospective review of medical records and radiographs for consecutive patients who underwent CHAOS for lower limb deformity correction at a tertiary centre between 2012 and 2020.
There were 70 cases in 56 patients, with the site of surgery being the femur in 48 cases, proximal tibia in 17 and distal tibia in 5 cases. Multiplanar correction was performed in 43 cases, and multilevel osteotomy was undertaken in 23 cases. Fixation was undertaken with intramedullary nailing (IMN) in 49 cases and locked plates in 21.The maximum corrections were 40° rotation, 20° coronal angulation, 51° sagittal angulation and 62-mm mechanical axis deviation (MAD). Deformity correction was mechanically satisfactory in all patients bar one who was undercorrected requiring revision. The mean patient global impression of change (PGIC) score was 6.2 out of 7.Overall complication rate was 12/70 (17%). Complications from femoral surgery included two nonunions, one case of undercorrection, one case of stiffness, one muscle hernia and one pulmonary embolism. Complications from tibial surgery were one compartment syndrome, one pseudoaneurysm of the anterior tibial artery requiring stenting, one transient neurapraxia of the common peroneal nerve, one locking plate fatigue failure, one seroma and one superficial wound infection.
Computerised hexapod-assisted orthopaedic surgery can be used for accurate correction of complex multilevel and multiplanar deformities of both the femur and tibia. The risk profile appears to differ between femoral and tibial surgeries, and also to that of traditional circular frame correction. Patients remain highly satisfied with both the functional and symptomatic outcomes.
French JMR, Filer J, Hogan K, . Computer Hexapod-assisted Orthopaedic Surgery for the Correction of Multiplanar Deformities throughout the Lower Limb. Strategies Trauma Limb Reconstr 2024;19(1):9-14.
计算机辅助六足机器人辅助骨科手术（CHAOS）是一种可在单次手术中利用微创技术高精度矫正复杂多平面、多节段畸形的方法。本研究旨在报告使用CHAOS技术治疗下肢畸形时所实现的矫正的可靠性、准确性和程度，以及患者报告的结果和并发症的风险因素。
对2012年至2020年在一家三级中心接受CHAOS治疗下肢畸形矫正的连续患者的病历和X线片进行回顾性研究。
56例患者共70例手术，手术部位为股骨48例，胫骨近端17例，胫骨远端5例。43例进行了多平面矫正，23例进行了多节段截骨。49例采用髓内钉（IMN）固定，21例采用锁定钢板固定。最大矫正角度为旋转40°、冠状面成角20°、矢状面成角51°和机械轴偏差（MAD）62mm。除1例矫正不足需翻修外，所有患者的畸形矫正力学效果均满意。患者总体变化印象（PGIC）评分平均为6.2（满分7分）。总体并发症发生率为12/70（17%）。股骨手术并发症包括2例骨不连、1例矫正不足、1例僵硬、1例肌肉疝和1例肺栓塞。胫骨手术并发症包括1例骨筋膜室综合征、1例胫前动脉假性动脉瘤需支架置入、1例腓总神经短暂性神经失用、1例锁定钢板疲劳断裂、1例血清肿和1例浅表伤口感染。
计算机辅助六足机器人辅助骨科手术可用于精确矫正股骨和胫骨的复杂多节段和多平面畸形。股骨和胫骨手术的风险情况似乎有所不同，与传统环形框架矫正也不同。患者对功能和症状改善结果仍高度满意。
French JMR, Filer J, Hogan K, 。计算机六足机器人辅助骨科手术矫正下肢多平面畸形。创伤肢体重建策略2024；19(1):9 - 14。
