Xu Mingliang, Li Renlong, Shi Rongjian, Chen Guoliang, Li Lin, Chen Jing, Wang Chun
Department of Foot and Ankle Surgery, Xuzhou Renci Hospital, Xuzhou, 221000, Jiangsu, China.
Shenyang Zhonghe Hospital Limited Company, No. 199 Xijiang Street, Yuhong District, Shenyang, 110034, Liaoning, China.
J Orthop Traumatol. 2025 Jun 21;26(1):38. doi: 10.1186/s10195-025-00849-8.
To investigate the effect of arthroscopic reduction combined with robot-guided screw placement on Hawkins type II fractures of the talus neck.
Clinical data from 42 patients with talus neck Hawkins type II fracture treated in the institution from November 2019 to January 2021 were selected. According to the blind envelope method, 21 patients were enrolled in the study group, and 21 patients were enrolled in the control group. The patients in the study group underwent arthroscopy-assisted reduction combined with orthopedic robot navigation screw placement surgery, while those in the control group underwent open reduction surgery.
All 42 patients were followed up. The patients in the study group were followed up for a mean of 14.76 (range, 12-17) months. No talus avascular necrosis or fracture nonunion were observed. Subtalar arthritis was reported in two cases. Patients in the control group were followed up for an average of 14.52 (ranging from 12 to 17) months, and no talus avascular necrosis or fracture nonunion was found. Incisional infection occurred in one case and subtalar arthritis in three cases. The difference between the two groups was statistically significant (P < 0.05) in the duration from injury to surgery, operation time, blood loss, incision length, and number of guide pin insertions. There was no significant difference between the two groups in ankle joint range of motion, the American Orthopedic Foot and Ankle Society ankle-hindfoot score at the last follow-up, and visual analogue scale of pain before operation and at the last follow-up (P > 0.05).
The management of Hawkins type II fracture of the talus neck using arthroscopy-assisted reduction combined with robot navigation screw placement yields satisfactory results and represents a viable treatment alternative that warrants consideration.
探讨关节镜下复位联合机器人引导螺钉置入治疗距骨颈Hawkins II型骨折的效果。
选取2019年11月至2021年1月在本机构治疗的42例距骨颈Hawkins II型骨折患者的临床资料。采用盲信封法，将21例患者纳入研究组，21例患者纳入对照组。研究组患者接受关节镜辅助复位联合骨科机器人导航螺钉置入手术，而对照组患者接受切开复位手术。
42例患者均获随访。研究组患者平均随访14.76（范围12 - 17）个月。未观察到距骨缺血性坏死或骨折不愈合。报告2例发生距下关节炎。对照组患者平均随访14.52（范围12至17）个月，未发现距骨缺血性坏死或骨折不愈合。发生1例切口感染，3例距下关节炎。两组在受伤至手术时间、手术时间、失血量、切口长度和导针插入次数方面差异有统计学意义（P < 0.05）。两组在踝关节活动范围、末次随访时美国矫形足踝协会踝 - 后足评分以及术前和末次随访时的视觉模拟疼痛评分方面差异无统计学意义（P > 0.05）。
采用关节镜辅助复位联合机器人导航螺钉置入治疗距骨颈Hawkins II型骨折效果满意，是一种可行的治疗选择，值得考虑。
