自研T型架闭合复位结合机器人导航治疗Gartland Ⅱ型儿童肱骨髁上骨折的疗效分析
Closed reduction with a self-developed T-frame plus robotic navigation to treat supracondylar humeral fractures of Gartland type Ⅲ in children
汤池 1白哲 1齐昵男 1岳思彤 1李野 1高泽锋 2牛成林 3张中礼4
作者信息
- 1. 哈尔滨市第五医院骨三科,哈尔滨 150040
- 2. 哈尔滨市第五医院骨十一科,哈尔滨 150040
- 3. 哈尔滨市第五医院科教科,哈尔滨 150040
- 4. 天津医院小儿骨科,天津 300202
- 折叠
摘要
目的 探讨自研T型架闭合复位结合机器人导航精准固定儿童肱骨髁上骨折的疗效.方法 回顾性分析2023年1月至2024年3月间在哈尔滨市第五医院接受手术治疗的67例Gartland Ⅲ型儿童肱骨髁上骨折患者资料.男35例,女32例;年龄(5.6±1.2)岁.所有患儿根据手术方式不同分为2组:对照组(使用闭合复位经皮克氏针内固定治疗)33例和研究组(使用自研T型架复位结合机器人导航进行经皮克氏针内固定治疗)34例.比较两组患儿手术时间、骨折解剖复位率、术中透视次数、术中穿针调整次数、末次随访时Flynn评分及并发症的发生率.结果 两组患儿术前一般资料比较差异无统计学意义(P＞0.05),具有可比性.所有患儿术后获(6.3±2.5)个月随访.研究组患儿的手术时间、末次随访时Flynn评分及并发症的发生率与对照组比较差异均无统计学意义(P＞0.05).研究组骨折解剖复位率(97.1％,33/34)显著高于对照组(54.5％,18/33),术中透视次数[(28.7±3.9)次]、穿针调整次数[(5.6±1.2)次]均显著低于对照组的(37.2±2.1)、(11.6±2.5)次,差异均有统计学意义(P＜0.05).结论 自研T型架对儿童难复性Gartland Ⅲ型肱骨髁上骨折能够起到很好的复位并临时固定的作用,可使术中使用机器人导航穿针固定时避免反复多次复位、调整穿针造成的医源性副损伤.
Abstract
Objective To study the efficacy of closed reduction with a self-developed T-frame plus robotic navigation in the treatment of supracondylar humeral fractures of Gartland type Ⅲ in children.Methods A retrospective study was conducted to analyze the data of 67 children with supracondylar fracture of Gartland typeⅢ who had undergone surgery at The Fifth Hospital of Harbin from January 2023 to March 2024.There were 35 males and 32 females with an age of(5.6±1.2)years.The children were divided into 2 groups according to different surgical methods.The control group(33 cases)was treated by closed reduction and internal fixation with percutaneous K-wire and the study group(34 cases)by closed reduction with a self-developed T-frame plus robotic navigation for internal fixation with percutaneous K-wire.The operation time,anatomical reduc-tion,intraoperative fluoroscopy frequency,intraoperative needle adjustment,Flynn score at the last follow-up and complications were compared between the 2 groups.Results There was no significant difference in the preoperative general data between the 2 groups,indicating comparability(P＞0.05).All children were followed up for(6.3±2.5)months after surgery.There were no significant differences in operation time,Fly-nn score at the last follow-up or incidence of complications between the study and the control groups(P＞0.05).The rate of anatomical reduction in the study group(97.1％,33/34)was significantly higher than that in the control group(54.5％,18/33),and the intraoperative fluoroscopy frequency[(11.6±2.5)times]and needle adjustment(5.6±1.2)times in the study group were significantly lower than those in the control group[(37.2±2.1)times and(28.7±3.9)times](P＜0.05).Conclusions In the treatment of supracondylar humeral fractures of Gartland type Ⅲ in children,our self-developed T-frame can play a good role in fracture reduction and temporary fixation,avoiding iatrogenic secondary injuries caused by freguent reduction and adjustment of needle threading in the course of robotic navigation.
关键词
儿童/外科手术,计算机辅助/机器人/肱骨髁上骨折Key words
Children/Surgery,computer-assisted/Robotics/Supracondylar humeral fracture引用本文复制引用
出版年
2024
NETL
NSTL
万方数据