Department of Hand Surgery, Beijing Jishuitan Hospital, Capital Medical University, No.31, Xin Jie Kou East Street, Xi Cheng District, Beijing, 100035, China.
Beijing Research Institute of Orthopedics, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, 100035, China.
J Orthop Surg Res. 2024 Nov 6;19(1):724. doi: 10.1186/s13018-024-05213-w.
The purpose of this study is to explore the feasibility and accuracy of a robot-assisted technique in four-corner fusion compared with traditional freehand operation.
Twenty cadaver specimens were randomly assigned to the robot-assisted group and freehand groups. Three screws were placed percutaneously to fix the capitate-lunate joint, lunate-triquetrum joint, and triquetrum-hamate-capitate joint in each specimen by robot-assisted or freehand technique. The offset between the actual and planned screw positions was determined by merging the images of intraoperative and postoperative CT scans in the robot-assisted group. The centrality of the screw, time-consuming, drilling attempts, and radiation exposure were compared between the two groups.
The mean offset between the actual and planned screw position was 1.09 (SD: 0.56) mm. The offset at the start point of the screw was significantly lower than that at the endpoint. There was no significant difference in the centrality of the screws, surgical time between the two groups. The number of drilling attempts and the radiation dose received by surgeons were significantly lower in the robot-assisted group.
Although there was no significant difference in screw centrality between the two groups, the slight offset between the actual and planned screw positions confirmed the feasibility of the robot-assisted technique in four-corner fusion. The robot-assisted technique has advantages in reducing the difficulty of surgery and protecting the surgeon from exposure to large doses of radiation.
本研究旨在探讨机器人辅助技术在四角融合中的可行性和准确性，与传统徒手操作相比。
将 20 个尸体标本随机分为机器人辅助组和徒手组。通过机器人辅助或徒手技术，在每个标本的头状骨-月骨关节、月骨-三角骨关节和三角骨-头状骨-月骨关节中经皮置入 3 枚螺钉。通过将机器人辅助组术中与术后 CT 扫描的图像合并，确定实际与计划螺钉位置之间的偏移量。比较两组之间的螺钉中心度、手术时间、钻孔尝试次数和辐射暴露量。
实际与计划螺钉位置之间的平均偏移量为 1.09（SD：0.56）mm。螺钉起点的偏移量明显低于终点。两组螺钉中心度、手术时间无显著差异。机器人辅助组的钻孔尝试次数和外科医生接受的辐射剂量明显减少。
尽管两组螺钉中心度无显著差异，但实际与计划螺钉位置之间的轻微偏移证实了机器人辅助技术在四角融合中的可行性。机器人辅助技术在降低手术难度和保护外科医生免受大剂量辐射暴露方面具有优势。
