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提高准确性并减少并发症:机器人辅助导航用于股骨远端骨折的逆行髓内钉固定术

Enhanced accuracy and reduced complications: robot-assisted navigation for retrograde intramedullary nailing in distal femoral fractures.

作者信息

He Quanjie, Xie Zhitao, Zhang Jingyu, Jiao Yongqiang, Zhang Yongtao, Hu Yongcheng

机构信息

Clinical School/College of Orthopedics, Tianjin Medical University, Tianjin, China.

Department of Orthopedics, Affiliated Hospital of Hebei Engineering University, Handan, China.

出版信息

Int Orthop. 2025 Jun;49(6):1519-1527. doi: 10.1007/s00264-025-06544-x. Epub 2025 Apr 25.

Abstract

PURPOSE

This research investigates the benefits of robot-assisted navigation systems in retrograde intramedullary nailing for distal femoral fractures and contrasts their outcomes with conventional surgical methods. This is a retrospective clinical study designed to compare the outcomes of these two approaches.

METHODS

This study included 56 distal femoral fracture patients treated between February 2020 and May 2023. Among them, 28 patients underwent robot-assisted retrograde intramedullary nailing (robot group), while 28 received conventional retrograde intramedullary nailing (traditional group). Surgical duration, intraoperative fluoroscopy frequency, number of guidewire insertions into the femoral medullary cavity, and intraoperative blood loss were recorded. Healing progress and fixation stability status were observed, and postoperative articular function was assessed using Neer's scoring system at a one year follow-up.

RESULTS

Baseline characteristics were comparable between the two groups, showing no statistically significant differences.The robot group demonstrated shorter operative time, fewer guidewire placements, reduced intraoperative hemorrhage and incision size compared to the traditional group (P < 0.05). While the Neer's score for postoperative joint function showed a higher excellent-to-good rate in the robot group, no significant difference was observed between the group (P > 0.05).

CONCLUSION

Compared with traditional surgical methods, robot-assisted retrograde intramedullary fixation for fractures of the distal femur offers advantages of being minimally invasive, more precise, requiring shorter operative times, and resulting in reduced blood loss, fluoroscopy exposure, and guidewire insertion attempts. These benefits may contribute to a reduction in postoperative complications.

摘要

目的

本研究探讨机器人辅助导航系统在股骨远端骨折逆行髓内钉固定中的益处,并将其结果与传统手术方法进行对比。这是一项回顾性临床研究,旨在比较这两种方法的结果。

方法

本研究纳入了2020年2月至2023年5月间治疗的56例股骨远端骨折患者。其中,28例患者接受了机器人辅助逆行髓内钉固定(机器人组),而28例接受了传统逆行髓内钉固定(传统组)。记录手术时间、术中透视频率、股骨骨髓腔内导丝插入次数及术中失血量。观察愈合进程和固定稳定性状况,并在一年随访时使用Neer评分系统评估术后关节功能。

结果

两组的基线特征具有可比性,无统计学显著差异。与传统组相比,机器人组手术时间更短、导丝置入次数更少、术中出血和切口尺寸更小(P < 0.05)。虽然机器人组术后关节功能的Neer评分优良率更高,但两组间无显著差异(P > 0.05)。

结论

与传统手术方法相比,机器人辅助股骨远端骨折逆行髓内固定具有微创、更精确、手术时间短、失血少、透视暴露少及导丝插入尝试次数少等优点。这些益处可能有助于减少术后并发症。

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